Hearing Characteristics of Stroke Patients: Prevalence and Characteristics of Hearing Impairment and Auditory Processing Disorders in Stroke Patients

Background: Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors. Purpose: The present study aimed to characterize and classify the hearing impairments, using a detailed audiological assessment test battery, in order to determine the level of clinical need and inform appropriate rehabilitation for this patient population. Research Design: A case–control study. Study Sample: Forty-two recruited stroke patients who were discharged from a stroke unit and 40 control participants matched for age. Data Collection and Analysis: All participants underwent pure-tone audiometry and immittance measurements including acoustic reflex threshold, transient-evoked otoacoustic emissions, auditory-evoked brainstem response, and a central auditory processing assessment battery, performed in a single session. Hearing impairments were classified as peripheral hearing loss (cochlear and neural type), central auditory processing disorder (CAPD), and as a combination of CAPD and peripheral hearing loss. Results: Overall mean hearing thresholds were not significantly different between the control and stroke groups. The most common type of hearing impairment in stroke patients was the combination type, “peripheral and CAPD,” in the 61- to 80-yr-old subgroup (in 55%), and auditory processing deficits in 18- to 60-yr-olds (in 40%), which were both significantly higher than in controls. Conclusions: This is the first study to examine hearing function in detail in stroke patients. Given the importance of hearing for the efficiency of communication, it is essential to identify hearing impairments and differentiate peripheral and central deficits to define an appropriate intervention plan.

Download Full-text

Hormones and Hearing: Central Auditory Processing in Women

Journal of the American Academy of Audiology ◽

10.3766/jaaa.17123 ◽

2019 ◽

Vol 30 (06) ◽

pp. 493-501

Author(s):

Skylar Trott ◽

Trey Cline ◽

Jeffrey Weihing ◽

Deidra Beshear ◽

Matthew Bush ◽

...

Keyword(s):

Hearing Loss ◽

Auditory Processing ◽

Auditory Brainstem ◽

Human Model ◽

Central Auditory Processing ◽

Hormonal Changes ◽

Hearing Sensitivity ◽

Organ Systems ◽

Significant Difference ◽

Brainstem Response

AbstractEstrogen has been identified as playing a key role in many organ systems. Recently, estrogen has been found to be produced in the human brain and is believed contribute to central auditory processing. After menopause, a low estrogen state, many women report hearing loss but demonstrate no deficits in peripheral hearing sensitivity, which support the notion that estrogen plays an effect on central auditory processing. Although animal research on estrogen and hearing loss is extensive, there is little in the literature on the human model.The aim of this study was to evaluate relationships between hormonal changes and hearing as it relates to higher auditory function in pre- and postmenopausal (Post-M) females.A prospective, group comparison study.Twenty eight women between the ages of 18 and 70 at the University of Kentucky were recruited.Participants were separated into premenopausal and peri-/Post-M groups. Participants had normal peripheral hearing sensitivity and underwent a behavioral auditory processing battery and electrophysiological evaluation. An analysis of variance was performed to address the aims of the study.Results from the study demonstrated statistically significant difference between groups, where Post-M females had difficulties in spatial hearing abilities as reflected on the Listening in Spatialized Noise Test–Sentences test. In addition, measures on the auditory brainstem response and the middle latency response reflected statistically significant differences between groups with Post-M females having longer latencies.Results from the present study demonstrated significant differences between groups, particularly listening in noise. Females who present with auditory complaints in spite of normal hearing thresholds should have a more extensive audiological evaluation to further evaluate possible central deficits.

Download Full-text

Hearing impairment among workers occupationally exposed to excessive levels of noise

Open Medicine ◽

10.2478/s11536-007-0034-2 ◽

2007 ◽

Vol 2 (3) ◽

pp. 313-318 ◽

Cited By ~ 2

Author(s):

Pavlina Gidikova ◽

Gospodinka Prakova ◽

Petar Ruev ◽

Gergana Sandeva

Keyword(s):

Hearing Loss ◽

Hearing Impairment ◽

Otoacoustic Emissions ◽

Gradual Increase ◽

Pure Tone Audiometry ◽

Noise Levels ◽

Distortion Products ◽

Occupationally Exposed ◽

Intermittent Noise ◽

Excessive Noise

AbstractPure tone audiometry screening and ear examinations were conducted among 138 males working as machine and equipment operators occupationally exposed to intermittent noise of 85 to 105 dBA. Hearing loss up to 30 dB (preserved socially adequate hearing) was found in 25 workers. The hearing impairment was confirmed by distortion products of otoacoustic emissions measurements. A sharp increase in the frequency of cases can be found among the workers with service length over 10 years. While the frequency of the cases among workers with service length below 10 years is 5.45%, it is 26.5% among the subjects with service length over 10 years, with a gradual increase as a result of the increase in exposure duration. A positive correlation (p < 0.05) was found between the frequency of hearing impairment among the workers and the years of exposure to excessive noise levels. Some measures for preventing occupational noise-induced hearing loss were suggested.

Download Full-text

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.

Download Full-text

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.

Download Full-text

Is there auditory impairment in Parkinson's disease?

Revista CEFAC ◽

10.1590/1982-021620182052418 ◽

2018 ◽

Vol 20 (5) ◽

pp. 573-582 ◽

Cited By ~ 1

Author(s):

Marcia da Silva Lopes ◽

Ailton de Souza Melo ◽

Ana Paula Corona ◽

Ana Caline Nóbrega

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Hearing Loss ◽

Auditory Processing ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Distortion Product ◽

Biological Variables ◽

Initial Stage ◽

Auditory Impairment

ABSTRACT Objective: to describe the audiological profile of a group of patients with Parkinson's disease and to investigate the association between hearing loss and the disease. Methods: 50 individuals with and 46 without Parkinson's disease underwent Pure Tone Audiometry, Otoacoustic Emissions by Distortion Product, and auditory processing tests. The results of the patients were compared to those obtained in individuals without the disease, according to clinical and biological variables. Results: in individuals with Parkinson's disease, 82% presented hearing loss, 53.5% alterations in Otoacoustic Emissions by Distortion Product, 78%, alterations in temporal processing, and 12%, changes in binaural integration. Individuals with the disease had a greater impairment in the recognition of duration patterns when compared to those without the disease, with a worse performance in men and in individuals aged between 42 and 65 years old and Hoehn and Yahr I and II stages. Conclusions: the profile found corresponds to descending sensorineural hearing loss and alteration in otoacoustic emissions, temporal ordering and noise gaps detection.Only losses in temporal order are associated with the disease, especially in men, individuals under the age of 65 and in the initial stage.

Download Full-text

Disabling hearing impairment in the Bangladeshi population

The Journal of Laryngology & Otology ◽

10.1017/s002221511400348x ◽

2015 ◽

Vol 129 (2) ◽

pp. 126-135 ◽

Cited By ~ 8

Author(s):

K H Tarafder ◽

N Akhtar ◽

M M Zaman ◽

M A Rasel ◽

M R Bhuiyan ◽

...

Keyword(s):

Hearing Loss ◽

Hearing Impairment ◽

Otitis Media ◽

Otoacoustic Emissions ◽

Otitis Media With Effusion ◽

Multiple Logistic Regression Analysis ◽

Pure Tone Audiometry ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Ear Wax

AbstractObjective:This study aimed to determine the prevalence of hearing impairment in Bangladeshi people of all ages.Methods:A nationally representative cross-sectional survey was carried out in 2013. A total of 4260 subjects (1774 males and 2486 females), with a mean age of 32 years, participated. Hearing impairment was determined by pure tone audiometry and otoacoustic emissions testing.Results:Disabling hearing loss (greater than 40 dB loss in adults, and greater than 30 dB loss in children younger than 15 years, in their better hearing ears) was present in 9.6 per cent (95 per cent confidence interval, 8.5–10.8 per cent) of the respondents. Hearing loss was more prevalent in socio-economically deprived people and in those older than 60 years. Multiple logistic regression analysis identified age, socio-economic deprivation, family history, impacted ear wax, chronic suppurative otitis media, otitis media with effusion, and otitis externa as the significant predictors of disabling hearing loss.Conclusion:Deafness prevention should focus mainly on chronic suppurative otitis media, otitis media with effusion, and impacted ear wax prevention, integrated within the primary healthcare system and addressing the equity issue.

Download Full-text

Auditory Processing Disorder Test Battery in European Portuguese—Development and Normative Data for Pediatric Population

Audiology Research ◽

10.3390/audiolres11030044 ◽

2021 ◽

Vol 11 (3) ◽

pp. 474-490

Author(s):

Jorge Humberto Martins ◽

Marisa Alves ◽

Susana Andrade ◽

Isabel Falé ◽

António Teixeira

Keyword(s):

Auditory Processing ◽

Otoacoustic Emissions ◽

Normative Data ◽

Pediatric Population ◽

Pure Tone Audiometry ◽

Auditory Training ◽

Central Auditory Processing ◽

Frequency Pattern ◽

Speech In Noise ◽

European Portuguese

There is an increasing need for state-of-the-art Central Auditory Processing assessment for Portuguese native speakers, applicable as early as possible. As a contribution to answering this need, this paper presents a new battery for Central Auditory Processing assessment for European Portuguese applicable to children aged 5 and above, named BAPA-PE, providing information regarding test selection and development. The battery consists of six behavioral tests: Staggered Spondaic Words (SSW) for European Portuguese, Filtered Speech, Speech in Noise, Detection Interval in Noise, Duration, and Frequency Pattern. The normative data for children aged 5 to 12 are also reported. A sample was obtained of 217 subjects without ear pathology and with typical development. Each age group was composed of at least 30 children. All children were evaluated using pure tone audiometry, speech audiometry, impedance, and otoacoustic emissions. Normative scores are reported for each of the six auditory processing tests. The assessment is applicable to young children (aged 5 and 6). The statistical analyses showed significant effects in scores of Age for all tests and of Ear for several tests. The main result from the work presented, the Auditory Processing Assessment Battery—European Portuguese (BAPA-PE), is available for clinical use with normative data. This battery is a new tool for behaviorism assessment of European Portuguese speakers with suspected central auditory pathology and for monitoring the results of auditory training.

Download Full-text

Hidden hearing deficits in military service members with persistent post concussive symptoms

Undersea and Hyperbaric Medicine ◽

10.22462/13.15.2019.4 ◽

2019 ◽

pp. 251-260

Author(s):

Anna Meehan ◽

◽

Donald Hebert ◽

Kayla Deru ◽

Lindell K. Weaver ◽

...

Keyword(s):

Hearing Loss ◽

Brain Injury ◽

Auditory Processing ◽

Military Service ◽

Service Members ◽

Central Auditory Processing ◽

Persistent Symptoms ◽

Military Service Members ◽

Brainstem Response ◽

Interpeak Latency

Introduction: Individuals with persistent symptoms after mild traumatic brain injury (mTBI) often have auditory complaints. In this study, we used the auditory brainstem response (ABR) to determine whether cochlear synaptopathy could explain auditory symptoms. Methods: 69 adult military service members with mTBI and 25 adults without brain injury (NCT01611194 and NCT01925963) completed pure-tone audiometry, ABR, and central auditory processing tests. All participants were male, ages 21-50. Results: 37/69 mTBI participants had measurable hearing loss, while another 20-30% had hearing complaints or tinnitus. While mTBI participants with measurable hearing loss had reduced wave I and III amplitude and decreased III-V interpeak latency, those with no measurable hearing loss did not significantly differ from controls on any ABR parameter. Those with measurable hearing loss were also more likely to have abnormal central auditory processing. mTBI participants with no measurable hearing loss but who reported hearing concerns had some ABR findings (III-V interpeak latency, I and V amplitudes, V/I amplitude ratio) more like the measurable hearing loss mTBI group than normative controls. Conclusion: Cochlear synaptopathy may have contributed to some of the auditory impairment in service members with mTBI with measurable hearing loss. However, these results are likely confounded by cochlear hair cell damage.

Download Full-text

Longstanding effect of recurrent Otitis Media with effusion on central auditory processing in Children

10.31234/osf.io/8q7kp ◽

2019 ◽

Author(s):

Iman Bahader

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Auditory Processing ◽

Auditory Brainstem Response ◽

Speech Intelligibility ◽

Otitis Media With Effusion ◽

Auditory Brainstem ◽

Central Auditory Processing ◽

Brainstem Response ◽

Conductive Hearing

Background: Auditory deprivation due to otitis media with effusion(OME) has been suggested and could be related to auditory processingproblem. Aim of the work: To assess central auditory processing functions in children having recurrent OME through behavioral and electrophysiological testing, and to correlate between them. Methodology: Sixty children of both genders were enrolled in this study and divided into 30 children with history of recurrent OME and 30 children of age and gender matched control group. All children were subjected to full history taking, basic audiological evaluation, speech intelligibility in noise test (SPIN), click evoked auditory brainstem response (click ABR) and speech evoked auditory brainstem response testing (speech ABR). Results: Comparing both groups revealed statistically significant depressed SPIN scores at different signal to noise ratios in study group even in absence of conductive hearing loss (CHL). Click ABR absolute latencies of wave I, III and V and interpeak latencies I-V and III-V were significantly prolonged due to CHL. Speech ABR showed significant wave V latency shift together with wave A delay, reduced amplitude, prolonged V-A duration and shallower slope even in absence of hearing loss. Conclusion: Children having recurrent OME showed brainstem abnormalities as detected by SPIN, click ABR and speech ABR tests even in absence of hearing loss.Keywords: Otitis media with effusion (OME), conductive hearing loss(CHL), speech auditory brainstem response (speech ABR) and speech intelligibility in noise test (SPIN).

Download Full-text

Hearing impairment in patients of hypothyroidism in sub Himalayan region

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203202 ◽

2020 ◽

Vol 6 (8) ◽

pp. 1494

Author(s):

Vikasdeep Gupta ◽

Sunder Singh Dogra ◽

Pardeep Bansal ◽

Kuldeep Thakur ◽

Vidhu Sharma ◽

...

Keyword(s):

Hearing Loss ◽

Hearing Impairment ◽

High Frequency ◽

Otoacoustic Emissions ◽

Pure Tone Audiometry ◽

Transluminal Angioplasty ◽

Prospective Clinical Study ◽

Thyroid Function Tests ◽

Distortion Product ◽

Serum T3

Background: The objective of the study was to assess the hearing impairment in patients of hypothyroidism.Methods: A prospective clinical study has done at a referral centre included 33 diagnosed patients of hypothyroidism in the age group of 15 to 65 years, fulfilling the inclusion and exclusion criteria who attended the outpatient department. The diagnosis of hypothyroidism was confirmed by thyroid function tests i.e., serum T3, T4 and TSH levels while hearing assessment was done using tuning fork tests, pure tone audiometry, impedance audiometry and otoacoustic emissions. Hearing impairment was measured in decibels of hearing loss, or dB HL and graded as mild, moderate, moderately severe, severe, or profound. Results: Percutaneous transluminal angioplasty showed 42.7% of the patients had high frequency sensorineural type of hearing loss. The air bone gap was not significant. On tympanometry, all the patients had type A graph and distortion product otoacoustic emissionss in all patients were pass.Conclusions: Acquired hypothyroidism affects primarily high frequency hearing thresholds causing high frequency sensorineural hearing loss, with little or no effect on lower frequencies.

Download Full-text