Factors associated with hearing loss in a normal-hearing guinea pig model of Hybrid cochlear implants

The Hybrid cochlear implant (CI), also known as Electro-Acoustic Stimulation (EAS), is a new type of CI that preserves residual acoustic hearing and enables combined cochlear implant and hearing aid use in the same ear. However, 30-55% of patients experience acoustic hearing loss within days to months after activation, suggesting that both surgical trauma and electrical stimulation may cause hearing loss. The goals of this study were to: 1) determine the contributions of both implantation surgery and EAS to hearing loss in a normal-hearing guinea pig model; 2) determine which cochlear structural changes are associated with hearing loss after surgery and EAS. Two groups of animals were implanted (n = 6 per group), with one group receiving chronic acoustic and electric stimulation for 10 weeks, and the other group receiving no direct acoustic or electric stimulation during this time frame. A third group (n = 6) was not implanted, but received chronic acoustic stimulation. Auditory brainstem response thresholds were followed over time at 1, 2, 6, and 16 kHz. At the end of the study, the following cochlear measures were quantified: hair cells, spiral ganglion neuron density, fibrous tissue density, and stria vascularis blood vessel density; the presence or absence of ossification around the electrode entry was also noted. After surgery, implanted animals experienced a range of 0-55 dB of threshold shifts in the vicinity of the electrode at 6 and 16 kHz. The degree of hearing loss was significantly correlated with reduced stria vascularis vessel density and with the presence of ossification, but not with hair cell counts, spiral ganglion neuron density, or fibrosis area. After 10 weeks of stimulation, 67% of implanted, stimulated animals had more than 10 dB of additional threshold shift at 1 kHz, compared to 17% of implanted, non-stimulated animals and 0% of non-implanted animals. This 1-kHz hearing loss was not associated with changes in any of the cochlear measures quantified in this study. The variation in hearing loss after surgery and electrical stimulation in this animal model is consistent with the variation in human patients. Further, these findings illustrate an advantage of a normal-hearing animal model for quantification of hearing loss and damage to cochlear structures without the confounding effects of chemical- or noise-induced hearing loss. Finally, this study is the first to suggest a role of the stria vascularis and damage to the lateral wall in implantation-induced hearing loss. Further work is needed to determine the mechanisms of implantation- and electrical-stimulation-induced hearing loss.

[Investigation of noise hazards and hearing status of workers in outdoor quarries]

OBJECTIVE

To investigate the noise hazards in open quarries and to provide a basis for further control of noise hazards.

METHODS

An investigation was performed during 2010 to 2011 among all open quarries in Deqing County of Zhejiang Province, China. The investigation included basic information of the quarries, the occupational health situation and noise intensity at the workplace, and the hearing loss of workers exposed to noise in quarry enterprises. The hearing test results were evaluated based on the Diagnostic criteria of occupational noise-induced hearing loss (GBZ 49-2007).

RESULTS

A total of 25 enterprises with open quarries were investigated, of which only 30.4% (17/56) workplaces met the national standard. The median noise level was 92.5 dB (A). Fifty-four (10.6%) out of 508 workers in the 25 enterprises were diagnosed with binaural hearing loss in the initial physical examination, with 18.3% (93/508) under surveillance. The rate of normal hearing among crushing workers, mechanists, drilling workers, and blasting workers ranged between 27.6% and 41.4%, which was significantly lower than that among workers exposed to slight noise hazards (80.0%) or other workers (63.7%) (P < 0.05). With increasing working years, the binaural hearing loss of crushing workers became serious.

CONCLUSION

Serious occupational noise hazards existed in most jobs in open quarries, with crushing workers, mechanists, drilling workers, and blasting workers most seriously jeopardized. Among crushing workers, those working in the first-line or unprotected second?line positions suffered more than the others. Further measures should be taken by the supervision department and the enterprises to control the noise hazards in open quarries.

Effect of low-level laser treatment on cochlea hair-cell recovery after acute acoustic trauma

We investigated the effect of low-level laser radiation on rescuing hair cells of the cochlea after acute acoustic trauma and hearing loss. Nine rats were exposed to noise. Starting the following day, the left ears (NL ears) of the rats were irradiated at an energy output of 100 to 165 mW/cm(2) for 60 min for 12 days in a row. The right ears (N ears) were considered as the control group. Frequency-specific hearing levels were measured before the noise exposure and also after the 1st, 3rd to 5th, 8th to 10th and 12th irradiations. After the 12th treatment, hair cells were observed using a scanning electron microscope. Compared to initial hearing levels at all frequencies, thresholds increased markedly after noise exposure. After the 12th irradiation, hearing threshold was significantly lower for the NL ears compared to the N ears. When observed using an electron microscope, the number of hair cells in the middle turn of the NL ears was significantly larger than that of the N ears. Our findings suggest that low-level laser irradiation promotes recovery of hearing thresholds after acute acoustic trauma.

[Comparative investigation of hearing injury in workers exposed to punching machine noise and to steady state noise]

OBJECTIVE

To compare the difference of effects on hearing injury between punching machine noise and steady state noise.

METHODS

The subjects of present study were 100 workers, included 38 workers exposed to punching machine noise from forging shops and 62 workers exposed to steady state noise from drawbench or abrasive dust workshops. The individual noise dosimetries were used to detect noise that workers exposed, and cumulative noise exposure (CNE) was then calculated. On the basis of GBZ 49-2007, the worker hearing was tested, and the results were assessed.

RESULTS

There were no differences of CNE between group exposed to punching machine noise and group exposed to steady state noise. The hearing loss rate (55.3%) at high frequency in workers exposed to punching machine noise was significantly higher than that (32.3%) in workers exposed to steady state noise (P < 0.01). CNE and the hearing loss rate at high frequency showed dose-response relationship (P < 0.01).

CONCLUSION

when the exposure levels of workers were similar, the hearing injury induced by punching machine noise may be significantly higher than that induced by steady state noise.

Otoacoustic emissions in normal-hearing workers exposed to different noise doses

INTRODUCTION

The otoacoustic emission test is useful in monitoring hearing changes not yet detectable in pure-tone audiometry, as well as in monitoring cochlear damage caused by exposure to noise.

OBJECTIVE

To evaluate distortion product otoacoustic emissions in normal-hearing workers exposed to different occupational noise doses.

MATERIALS AND METHOD

This is a cohort prospective study performed in metalworking industries, in which normal-hearing workers were assessed by being divided into three different groups: GI not exposed, GII sporadically exposed and GIII often exposed to occupational noise.

RESULTS

Otoacoustic emission alterations were found in groups II and III bilaterally. Both in the amplitude and in the signal/noise ratio it was observed that as higher was the frequency, worse were the results of GII and GIII (p > 0.001), and the greater the exposure dose is, the lower the averages found in otoacoustic emission.

CONCLUSION

The otoacoustic emissions are worse in the exposed groups compared to the unexposed group and the greater are the noise dose, worse are the results.

Effectiveness of 4-hydroxy phenyl N-tert-butylnitrone (4-OHPBN) alone and in combination with other antioxidant drugs in the treatment of acute acoustic trauma in chinchilla

Acute acoustic trauma (AAT) results in oxidative stress to the cochlea through overproduction of cellular reactive oxygen, nitrogen, and other free radical species appearing from 1 h to 10 days after noise exposure. It has been shown that N-acetyl-L-cysteine (NAC), a glutathione prodrug, and acetyl-L-carnitine (ALCAR), a mitochondrial biogenesis agent, are effective in reducing noise-induced hearing loss. Phenyl N-tert-butylnitrone (PBN), a nitrone-based free radical trap, appears to suppress oxidative stress in a variety of disorders and several biological models. In this study, we tested whether 4-hydroxy PBN (4-OHPBN), a major metabolite of PBN, administered 4 h after noise exposure is effective in treating noise-induced hearing loss and whether a combination of antioxidant drugs (4-OHPBN plus NAC and 4-OHPBN plus NAC plus ALCAR) provides greater efficacy in attenuating AAT since each agent addresses different injury mechanisms. Chinchilla were exposed to a 105 dB octave-band noise centered at 4 kHz for 6 h. 4-OHPBN and combinations of antioxidant drugs were intraperitoneally administered beginning 4 h after noise exposure. Hearing threshold shifts in auditory brainstem responses and missing outer hair cell counts were obtained. 4-OHPBN reduced threshold shifts in a dose-dependent manner while both drug combinations showed greater effects. These results demonstrate that 4-OHPBN and combinations of antioxidants can effectively treat acute acoustic trauma and drug combinations may increase the effectiveness of treatment and decrease the required individual medication dose.

Ototoxicity of organic solvents - from scientific evidence to health policy

The scientific workshop, organized under the 6th European Framework Programme, the Marie Curie Host Fellowship for the Transfer of Knowledge "NoiseHear" Project, by the Nofer Institute of Occupational Medicine (Łódź, Poland, 15-16 November 2006), gathered world specialists in noise, chemicals, and ototoxicity, including hearing researchers, toxicologists, otolaryngologists, audiologists and occupational health physicians.The workshop examined the evidence and the links between isolated exposure to organic solvents, combined exposure to noise and solvents, and effects on the auditory system. Its main purpose was to review the key scientific evidence to gather the necessary knowledge for developing adequate occupational health policies. This paper summarizes the workshop sessions and subsequent discussions.