Interchangeability of three different methods of calculating Pure Tone Average in patients with vestibular schwannoma to assess the risk of surgery-related hearing loss

2020 ◽  
Vol 74 (4) ◽  
pp. 1-5
Author(s):  
Aleksandra Ochal-Choińska ◽  
Magdalena Lachowska ◽  
Katarzyna Kurczak ◽  
Kazimierz Niemczyk

Background: Patients with vestibular schwannoma (VS) most commonly present with hearing threshold reduction for high frequencies and a falling type of audiometric curve. However, it is doubtful whether all Pure Tone Averages described in the literature characterize patients with VS correctly, as the type of PTA which comprises higher frequencies may be more appropriate for hearing status assessment in those patients. Aim: The aim of this study was to analyze 3 common methods of calculating Pure Tone Averages (PTA1 - 500, 1000, 2000 and 3000 Hz; PTA2 - 500, 1000, 2000 and 4000 Hz; PTA3 – 500, 1000 and 2000 Hz) and to determine which of them is the most reliable for the assessment of VS patients. Material and Methods: The study group included 86 patients operated due to vestibular schwannoma accessed via the middle cranial fossa. Results: Regarding method of calculating Pure Tone Averages (PTA1, PTA2 and PTA3) identical or similar correlations were found between the preoperative values of Pure Tone Averages (PTA1, PTA2 and PTA3) and surgery-related hearing loss, as well as individual parameters of audiologic tests. Conclusions: Pure Tone Averages calculated according to 3 different methods (PTA1, PTA2, PTA3) may be used interchangeably in the assessment of hearing in VS patients.

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Francesco Martines ◽  
Daniela Bentivegna ◽  
Fabiola Di Piazza ◽  
Enrico Martines ◽  
Vincenzo Sciacca ◽  
...  

Objective. 312 tinnitus sufferers were studied in order to analyze: the clinical characteristics of tinnitus; the presence of tinnitus-age correlation and tinnitus-hearing loss correlation; the impact of tinnitus on subjects' life and where possible the etiological/predisposing factors of tinnitus.Results. There is a slight predominance of males. The highest percentage of tinnitus results in the decades 61–70. Of the tinnitus sufferers, 197 (63.14%) have a hearing deficit (light hearing loss in 37.18% of cases). The hearing impairment results of sensorineural type in 74.62% and limited to the high frequencies in 58.50%. The tinnitus is referred as unilateral in 59.93%, a pure tone in 66.99% and 10 dB above the hearing threshold in 37.7%. It is limited to high frequencies in 72.10% of the patients with sensorineural hearing loss (SNHL) while the 88.37% of the patients with high-frequency SNHL have a high-pitched tinnitus ( ).Conclusion. Hearing status and age represent the principal tinnitus related factors; there is a statistically significant association between high-pitched tinnitus and high-frequency SNHL. There is no significant correlation between tinnitus severity and tinnitus loudness confirming the possibility that neural connection involved in evoking tinnitus-related negative reactions are governed by conditioned reflexes.


2016 ◽  
Vol 125 (4) ◽  
pp. 845-852 ◽  
Author(s):  
Seyed H. Mousavi ◽  
Ajay Niranjan ◽  
Berkcan Akpinar ◽  
Marshall Huang ◽  
Hideyuki Kano ◽  
...  

OBJECTIVE In the era of MRI, vestibular schwannomas are often recognized when patients still have excellent hearing. Besides success in tumor control rate, hearing preservation is a main goal in any procedure for management of this population. The authors evaluated whether modified auditory subclassification prior to radiosurgery could predict long-term hearing outcome in this population. METHODS The authors reviewed a quality assessment registry that included the records of 1134 vestibular schwannoma patients who had undergone stereotactic radiosurgery during a 15-year period (1997–2011). The authors identified 166 patients who had Gardner-Robertson Class I hearing prior to stereotactic radiosurgery. Fifty-three patients were classified as having Class I-A (no subjective hearing loss) and 113 patients as Class I-B (subjective hearing loss). Class I-B patients were further stratified into Class I-B1 (pure tone average ≤ 10 dB in comparison with the contralateral ear; 56 patients), and I-B2 (> 10 dB compared with the normal ear; 57 patients). At a median follow-up of 65 months, the authors evaluated patients' hearing outcomes and tumor control. RESULTS The median pure tone average elevations after stereotactic radiosurgery were 5 dB, 13.5 dB, and 28 dB in Classes I-A, I-B1, and I-B2, respectively. The median declines in speech discrimination scores after stereotactic radiosurgery were 0% for Class I-A (p = 0.33), 8% for Class I-B1 (p < 0.0001), and 40% for Class I-B2 (p < 0.0001). Serviceable hearing preservation rates were 98%, 73%, and 33% for Classes I-A, I-B1, and I-B2, respectively. Gardner-Robertson Class I hearing was preserved in 87%, 43%, and 5% of patients in Classes I-A, I-B1, and I-B2, respectively. CONCLUSIONS Long-term hearing preservation was significantly better if radiosurgery was performed prior to subjective hearing loss. In patients with subjective hearing loss, the difference in pure tone average between the affected ear and the unaffected ear was an important factor in long-term hearing preservation.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-215
Author(s):  
Rahul Sharma ◽  
Anil Lalwani ◽  
Justin Golub

Abstract The progression and asymmetry of age-related hearing loss has not been well characterized in those 80 years of age and older because public datasets mask upper extremes of age to protect anonymity. We aimed to model the progression and asymmetry of hearing loss in the older old using a representative, national database. This was a cross-sectional, multicentered US epidemiologic analysis using the National Health and Nutrition Examination Study (NHANES) 2005-2006, 2009-2010, and 2011-2012 cycles. Subjects included non-institutionalized, civilian adults 80 years and older (n=621). Federal security clearance was granted to access publicly-restricted age data. Outcome measures included pure-tone average air conduction thresholds and the 4-frequency pure tone average (PTA). 621 subjects were 80 years old or older (mean=84.2 years, range=80-104 years), representing 10,600,197 Americans. Hearing loss exhibited constant acceleration across the adult lifespan at a rate of 0.0052 dB/year2 (95% CI = 0.0049, 0.0055). Compounded over a lifetime, the velocity of hearing loss would increase five-fold, from 0.2 dB loss/year at age 20 to 1 dB loss/year at age 100. This model predicted mean PTA within 2 dB of accuracy for most ages between 20 and 100 years. There was no change in the asymmetry of hearing loss with increasing age over 80 years (linear regression coefficient of asymmetry over age=0.07 (95% CI=-0.01, 0.24). In conclusion, hearing loss steadily and predictably accelerates across the adult lifespan to at least age 100, becoming near-universal. These population-level statistics will guide treatment and policy recommendations for hearing health in the older old.


2021 ◽  
Author(s):  
Scott B. Shapiro ◽  
Nathan Kemper ◽  
Austin Jameson ◽  
Michael Hazenfield ◽  
Noga Lipschitz ◽  
...  

2021 ◽  
pp. 1-14
Author(s):  
Sarah M. Theodoroff ◽  
Frederick J. Gallun ◽  
Garnett P. McMillan ◽  
Michelle Molis ◽  
Nirmal Srinivasan ◽  
...  

Purpose Type 2 diabetes mellitus (DM2) is associated with impaired hearing. However, the evidence is less clear if DM2 can lead to difficulty understanding speech in complex acoustic environments, independently of age and hearing loss effects. The purpose of this study was to estimate the magnitude of DM2-related effects on speech understanding in the presence of competing speech after adjusting for age and hearing. Method A cross-sectional study design was used to investigate the relationship between DM2 and speech understanding in 190 Veterans ( M age = 47 years, range: 25–76). Participants were classified as having no diabetes ( n = 74), prediabetes ( n = 19), or DM2 that was well controlled ( n = 24) or poorly controlled ( n = 73). A test of spatial release from masking (SRM) was presented in a virtual acoustical simulation over insert earphones with multiple talkers using sentences from the coordinate response measure corpus to determine the target-to-masker ratio (TMR) required for 50% correct identification of target speech. A linear mixed model of the TMR results was used to estimate SRM and separate effects of diabetes group, age, and low-frequency pure-tone average (PTA-low) and high-frequency pure-tone average. A separate model estimated the effects of DM2 on PTA-low. Results After adjusting for hearing and age, diabetes-related effects remained among those whose DM2 was well controlled, showing an SRM loss of approximately 0.5 dB. Results also showed effects of hearing loss and age, consistent with the literature on people without DM2. Low-frequency hearing loss was greater among those with DM2. Conclusions In a large cohort of Veterans, low-frequency hearing loss and older age negatively impact speech understanding. Compared with nondiabetics, individuals with controlled DM2 have additional auditory deficits beyond those associated with hearing loss or aging. These results provide a potential explanation for why individuals who have diabetes and/or are older often report difficulty understanding speech in real-world listening environments. Supplemental Material https://doi.org/10.23641/asha.16746475


Revista CEFAC ◽  
2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Georgea Espindola Ribeiro ◽  
Daniela Polo Camargo da Silva

ABSTRACT Purpose: to survey the national and international literature on the impacts of the coronavirus infection on the auditory system. Methods: an integrative review with search in the BIREME, PubMed, Scopus, and Web of Sciences databases. Inclusion criteria: articles in Portuguese and English whose subject was the coronavirus infection and its effects on the auditory system. Exclusion criteria: information from books and/or chapters, letters to editors, review articles, experience reports. The search strategy was based on the following combined descriptors, respectively in Portuguese and English: “Infecções por coronavírus”, “Audição”, “Perda auditiva”, “Coronavirus infections”, “Hearing”, “Hearing Loss”. Results: out of 43 articles found, two approached the issue. The first study assessed 20 patients that tested positive for COVID-19, though asymptomatic, who underwent pure-tone threshold audiometry and otoacoustic emissions. A significant increase in the auditory thresholds at high frequencies and a smaller response amplitude in the transient evoked otoacoustic emissions of those who tested positive for COVID-19 were observed when compared to that of controls. The second study reported the case of an asymptomatic 35-year-old COVID-19 female patient, who complained of otalgia and tinnitus, after being contaminated. The pure-tone threshold audiometry and tympanometry indicated mild unilateral (right ear) conductive hearing loss, with a type B tympanometric curve on that side. Conclusion: the studies included in this review showed different consequences of COVID-19 on hearing, with possible impairments on the sensory and mechanical structures of the auditory system. The knowledge of COVID-19 is limited, and further studies on its real impact on the auditory system are necessary.


1998 ◽  
Vol 119 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Juha-Pekka Vasama ◽  
Jyrki P. Mäkelä ◽  
Hans A. Ramsay

We recorded auditory-evoked magnetic responses with a whole-scalp 122-channel neuromagnetometer from seven adult patients with unilateral conductive hearing loss before and after middle ear surgery. The stimuli were 50-msec 1-kHz tone bursts, delivered to the healthy, nonoperated ear at interstimulus intervals of 1, 2, and 4 seconds. The mean preoperative pure-tone average in the affected ear was 57 dB hearing level; the mean postoperative pure-tone average was 17 dB. The 100-msec auditory-evoked response originating in the auditory cortex peaked, on average, 7 msecs earlier after than before surgery over the hemisphere contralateral to the stimulated ear and 2 msecs earlier over the ipsilateral hemisphere. The contralateral response strengths increased by 5% after surgery; ipsilateral strengths increased by 11%. The variation of the response latency and amplitude in the patients who underwent surgery was similar to that of seven control subjects. The postoperative source locations did not differ noticeably from preoperative ones. These findings suggest that temporary unilateral conductive hearing loss in adult patients modifies the function of the auditory neural pathway. (Otolaryngol Head Neck Surg 1998;119:125-30.)


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