Childhood hearing impairment and fertility in Norway

There is a lack of studies assessing how hearing impairment relates to reproductive outcomes. We examined whether childhood hearing impairment (HI) affects reproductive patterns based on longitudinal Norwegian population level data for birth cohorts 1940–1980. We used Poisson regression to estimate the association between the number of children ever born and HI. The association with childlessness is estimated by a logit model. As a robustness check, we also estimated family fixed effects Poisson and logit models. Hearing was assessed at ages 7, 10 and 13, and reproduction was observed at adult ages until 2014. Air conduction hearing threshold levels were obtained by pure-tone audiometry at eight frequencies from 0.25 to 8 kHz. Fertility data were collected from Norwegian administrative registers. The combined dataset size was N = 50,022. Our analyses reveal that HI in childhood is associated with lower fertility in adulthood, especially for men. The proportion of childless individuals among those with childhood HI was almost twice as large as that of individuals with normal childhood hearing (20.8% vs. 10.7%). The negative association is robust to the inclusion of family fixed effects in the model that allow to control for the unobserved heterogeneity that are shared between siblings, including factors related to the upbringing and parent characteristics. Less family support in later life could add to the health challenges faced by those with HI. More attention should be given to how fertility relates to HI.

Evaluation of the effects of Covid-19 on cochleovestibular system with audiovestibular tests

Purpose The purpose of the present study was to investigate the effects of COVID-19 on audiovestibular system with Transiently Evoked Distortion Otoacoustic Emissions (TOAE), Distortion Product Otoacoustic Emissions (DPOAE), video head impulse test (vHIT) and caloric test. Methods Audiovestibular findings of 24 patients with moderate/severe COVID-19 and 24 healthy controls were compared using pure tone audiometry, tympanometry, TOAE, DPOAE, caloric test, and vHIT. Results On audiometry, the pure tone averages of the COVID-19 patients were higher than the controls ( P = .038). The TEOAE amplitudes at 4000 and 5000 Hz ( P = .006 and P < .01), and DPOAE amplitudes at 3000, 6000, and 8000 Hz ( P < .001, P = .003 and P < .001) were significantly lower in COVID-19 patients compared to the controls. On vestibular tests, there was no significant difference between the caloric test results of the patients and the controls ( P > .05). On vHIT testing, amplitudes of right semicircular canal was found to be significantly lower in COVID-19 group compared to the control group ( P = .008). Conclusion COVID-19 may affect inner ear functions causing a subtle damage in the outer hair cells and lateral semicircular canals. It must be kept in mind that COVID-19 may cause cochleovestibular problems.

A comparative study between endoscopic and microscopic type 1 tympanoplasty

<p><strong>Background:</strong> The current study aims to compare type 1 microscopic tympanoplasty and endoscopic tympanoplasty and draws an evidence-based conclusion regarding the outcome.</p><p><strong>Methods:</strong> This randomized controlled clinical study consists of 60 patients, in which 30 cases allocated as group 1 underwent endoscopic myringoplasty, and 30 cases allocated as group 2 underwent conventional myringoplasty. Tympanic membrane (TM), pure tone audiometry (PTA) evaluated preoperatively and at 3 months postoperative follow-up.</p><p><strong>Results:</strong> Demographic distribution between the groups does not show a significant difference (χ2=6.67, p=0.16). There was no significant difference observed between TM perforation size between the groups (χ2=2.32, p=0.51). For the preoperative AB gap in group 1, the mean ABG was 28.20±2.67 and in group 2 was 28.20±0.80. The postoperative AB gap in group 1, the mean ABG was 17.40±3.01, and in group 2, the mean ABG was 19.67±2.93. The mean difference is 9.13, and it shows a statistically significant difference (p=0.001). The mean duration of surgery in group 1 was 130.83±34.84 and in group 2 was 168.33±16.88 min (p=0.001). In both groups, 90% have intact graft, and in 10% of patients’ residual perforation is present. The mean duration of hospitalization in group1 is 4.10±0.09 days and in group 2 is 4.97±0.18 days.</p><p><strong>Conclusions:</strong> By using the endoscopic addition, minimal invasive tympanoplasty can made possible the similar graft success rate with minimal pain. Endoscopic tympanoplasty uses very less operative time than microscopic surgery.</p><p> </p>

Predicting speech discrimination scores from pure-tone thresholds—A machine learning-based approach using data from 12,697 subjects

Diagnostic tests for hearing impairment not only determines the presence (or absence) of hearing loss, but also evaluates its degree and type, and provides physicians with essential data for future treatment and rehabilitation. Therefore, accurately measuring hearing loss conditions is very important for proper patient understanding and treatment. In current-day practice, to quantify the level of hearing loss, physicians exploit specialized test scores such as the pure-tone audiometry (PTA) thresholds and speech discrimination scores (SDS) as quantitative metrics in examining a patient’s auditory function. However, given that these metrics can be easily affected by various human factors, which includes intentional (or accidental) patient intervention, there are needs to cross validate the accuracy of each metric. By understanding a “normal” relationship between the SDS and PTA, physicians can reveal the need for re-testing, additional testing in different dimensions, and also potential malingering cases. For this purpose, in this work, we propose a prediction model for estimating the SDS of a patient by using PTA thresholds via a Random Forest-based machine learning approach to overcome the limitations of the conventional statistical (or even manual) methods. For designing and evaluating the Random Forest-based prediction model, we collected a large-scale dataset from 12,697 subjects, and report a SDS level prediction accuracy of 95.05% and 96.64% for the left and right ears, respectively. We also present comparisons with other widely-used machine learning algorithms (e.g., Support Vector Machine, Multi-layer Perceptron) to show the effectiveness of our proposed Random Forest-based approach. Results obtained from this study provides implications and potential feasibility in providing a practically-applicable screening tool for identifying patient-intended malingering in hearing loss-related tests.

Association Between Sensorineural Hearing Loss and Various Stages of Chronic Kidney Disease

Objectives To compare the proportion of sensorineural hearing impairment (SHI) among patients of chronic kidney disease (CKD) stages 3&4 with CKD stage 5. Materials and Methods This is a cross-sectional study of 30 patients with CKD stages 3 and 4 and 30 patients in stage 5. All patients had an audiological evaluation with pure tone audiometry. Results Our study had 49 males (82%) and 11 females (18%), with the age ranging from 20 to 60 years (mean: 45.13 years). The mean SHI values in stage 3&4 were 28.44 dB and in CKD stage 5 was 31.22 dB. In the right ear, the mean hearing loss in stage 3, stage 4, and stage 5 was 28.17 dB, 28.67 dB, and 31.84 dB, respectively. In the left ear, the mean SHI values in stage 3, stage 4, and stage 5 were 27.05 dB, 31.89 dB, and 30.61 dB, respectively.The mean SHI in stage 3&4 for age group 20 to 30 years was 13.66 dB, for 31 to 40 years was 26.33 dB, for 41 to 50 years was 35.18 dB, for 51 to 60 years was 37.12 dB. The mean SHI in stage 5 for the age group of 20 to 30 years was 16.48 dB, for 31 to 40 years was 28.29 dB, for 41 to 50 years was 31.82 dB, for 51 to 60 years was 34.35 dB. There was a significant correlation between hearing loss and CKD with respect to age (p < 0.001). The duration of renal illness and associated comorbidities was not a significant contributor to hearing loss in our study (p > 0.05). Conclusion As per our study, with progression in the stage of chronic kidney disease, the hearing loss also increased indicating a possible link between the two. We also noted that the hearing loss increased with the increasing age.

Prevalence of Vestibular Dysfunction with Presbycusis among Elderly in Malaysia

Objectives: This study aims to determine the prevalence of vestibular dysfunction in the Malaysian elderly and its association with presbycusis, age and other associated risk factors. Methods: A cross-sectional study was undertaken in a tertiary otorhinolaryngology department and the community. Adults aged 60 years and above who attended the ORL CLINIC with or without presbycusis were invited to participate. The main outcome measures, including the Malay Version Vertigo Symptoms Scale, pure tone audiometry and vestibular assessment, were obtained using a Video Head Impulse Test (VHIT). Results: The prevalence of vestibular dysfunction with presbycusis in the study population of 135 participants was 46.7 per cent (95 per cent confidence interval, 24.0 to 36.2 per cent). The median age was 68 years (range, 60–86 years). The A chi-square test of independence showed that there was significant association between Presbycusis and Tinnitus, X2 (1, N = 135) = 97.37, p < .001. A chi-square test of independence was performed to examine the relation between presbycusis and dizziness. The relation between these variables was significant, X2 (2, N = 135) = 28.42, p < .001. A chi-square test of independence showed that there was no significant association between presbycusis and VHIT, X2 (1, N = 135) = .01, p = .938. Conclusion: Vestibular dysfunction is independently associated with ageing and presbycusis. More research investigating the advantages of additional screening for vestibular dysfunction in older presbycusis patients is needed. Key words: Elderly; Presbycusis; Vestibular dysfunction; Video Head Impulse Test (VHIT)

EFFICACY OF PERMEATAL ENDOSCOPIC MYRINGOPLASTY IN INACTIVE (MUCOSAL) CHRONIC OTITIS MEDIA

Objective: To determine the efficacy of permeatal ednoscopic myringoplasty, in inactive (mucosal) COM regarding, graft take and hearing improvement. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Pak Emirates Military Hospital, Rawalpindi, from Aug 2019 to Feb 2020. Methodology: This was conducted on a sample size of n=100. Patients having inactive (mucosal) COM with dry central small, medium and large perforations were included. Patients were divided in to three groups on the basis of age, group A 15-30 years, group B 31-45 years and group C 46-60 years. All the patients underwent per-meatal endoscopic myringoplasty, without raising the tympano-meatal flap, under general anesthesia. Patients were followed up over a period of six months. Graft take was assessed by microscopy. Hearing was assessed by Pure Tone Audiometry (PTA) with improvement in air bone gap to 15db as primary end point. Data was collected on structured performa. Data was analyzed using SPSS version 17. Results: In this study, 33 (33%) were males and 67 (67%) were females. Age ranged 15-60 years. Out of 5 patients lost to follow up. A total of 95 completed their follow up. Based on age of the patients, in group A, successful graft take was 100%. In group B, it was 91% & in group C it dropped to 46%. On the basis of tympanic membrane perforation size, the graft success rate in small perforations was 94.8%; in medium sized perforations it was 86.8% and in large sized perforations of tympanic membrane it was........

OCCUPATIONAL NOISE INDUCED HEARING LOSS: IT’S FREQUENCY & RISK FACTORS

Objective: To determine the frequency and risk factors of occupational noise induced hearing loss. Study Design: Cross sectional study. Place and Duration of Study: Dispensary Unit of Jaith Bhuta Sugar Mill near Rahim Yar Khan, Southern Punjab.from Aug 2017 to Jan 2018. Methodology: This study was conducted using nonprobability consecutive sampling. n=300 workers of bothgenders aged 18-40 years were assessed. Basic demographic parameters, otoscopic examination and Pure Tone Audiometry were used for data collection. The Data was analyzed by using SPSS version 21. Results: Study included 215 (71.7%) males and 85 (28.3%) females with male to female ratio of 2.53: 1 and meanage of 28.34 ± 4.61 years. The frequency rate of hearing impairment (HI) was 90 (30%) out of 300 respondents inthis study. Out of 70 (100%) of respondents were affected with duration of job of 6-10 years. There was significant association between gender, age, education, duration of noise exposure with occupational noise induced hearing loss with p-value <0.001. Conclusion: There was high frequency of occupational noise induced hearing loss (ONIHL) with significantrisk factors being level and duration of exposure to noise (ETN), age, gender, education and hearing protectivedevices (HPD)’s.

HEARING HANDICAP IN OLDER ADULTS: A MULTI-CENTER STUDY

Objective: To determine the level of hearing handicap and its age and gender association in older adults. Study Design: Cross sectional analytical study. Place and Duration of Study: Study conducted at Ear, Nose & Throat outpatients of Yusra General Hospital, National Institute of Rehabilitation Medicine Islamabad and Cantonment General Hospital Rawalpindi, from Jul to Sep 2017. Methodology: We recruited two hundred cases of self-reported hearing difficulty, using non-probability consecutive sampling, who fulfilled inclusion criteria. After recording demographic details including history, subjects were screened by the Screening Version of Hearing Handicap Inventory for the Elderly (HHIE-S). Followed by otoscopy and pure tone audiometry. Analysis was done using SPSS-24. Results: Study revealed 133 (65.5%) males and 67 (33.5%) females with mean age of 65.45 ± 7.50 years. Out of 179 (89.5%) had significantly high level of hearing handicap with HHIE-S score >43, while 21 (10.5%) revealed mild to moderate handicap with score of 17-42. Hearing handicap was significantly associated with aging (p<0.001), while no significant gender association was noted. Hearing loss was mainly of sensory-neural type 192 (96%). Conclusion: In older adults with self-reported hearing loss, high level of hearing handicap was present in majority (89.5%) and mild to moderate in 10.5%, with significant association with aging and hearing loss was predominantly sensory- neural type.