Investigating sudden hearing loss in adults

Contribution of Audiogram Classification in Evaluating Vestibular Dysfunction in Sudden Sensorineural Hearing Loss With Vertigo

Object: We aimed to identify the relationship between vertigo symptoms and the involvement of vestibular dysfunction in sudden sensorineural hearing loss (SSNHL) and the contribution of audiogram classification.

Methods: A total of 50 patients with unilateral SSNHL were retrospectively divided into the vertigo group and non-vertigo group depending on the presence of vertigo. The involved vestibular end organs (VEOs) were verified by a battery of vestibular function tests including video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular VEMP (oVEMP). The correlations of audiogram configurations, initial pure-tone average (PTA), number of involved VEOs, prognosis (complete recovery rate), and vestibular functions were analyzed between the two groups. Additionally, the vestibular functions in a subgroup of profound SSNHL patients were further compared within groups with or without vertigo.

Results: Significant differences in the initial audiogram configurations (p = 0.033) and the abnormal rates of the posterior semicircular canal (PSC) (p = 0.035) and oVEMP (p = 0.046) were found between the two groups. The number of involved VEOs was related to the initial PTA in the vertigo group (p = 0.002, r = 0.541) and non-vertigo group (p = 0.042, r = 0.446). The prognosis was related to the abnormal rate of cVEMP and the number of involved VEOs in both vertigo group (p = 0.008, r = 0.482; p = 0.039, r = 0.385, respectively) and non-vertigo group (p = 0.016, r = 0.520; p = 0.022, r = 0.495, respectively), and it was especially related to the audiogram configurations in the vertigo group (p < 0.001, r = 0.692). However, after classification by audiogram configurations, there was no statistical difference in the abnormal rates of all vestibular function tests or the number of involved VEOs between the profound SSNHL patients with or without vertigo.

Conclusion: The relationship between the involvement of vestibular dysfunction and vertigo symptoms in patients with SSNHL was significantly different before and after audiogram classification. When evaluating the vestibular dysfunction in SSNHL patients, more attention should be paid to the audiogram configuration.

Demographic and Socioeconomic Disparities in Life Expectancy With Hearing Impairment in the United States

OBJECTIVES

Hearing impairment is one of the most common disabilities among older people, and its prevalence will increase as the U.S. population ages. However, little is known about social disparities in onset or transitions into and out of hearing impairment, nor how these transitions impact years of life to be spent impaired.

METHOD

We investigate the number of years an "average" person can expect to live with and without hearing impairment after age 50; sex, race, educational, and regional differences in these expectancies; and the implication of hearing impairment for remaining life expectancy. Bayesian multistate life table methods are applied to 9 waves of data from the Health and Retirement Study (1998-2014) to investigate social disparities in life expectancy with hearing impairment (n = 20,200) for the general population, people hearing impaired at age 50, and people hearing unimpaired at age 50.

RESULTS

Men, Hispanics, persons with less educational attainment, and those born in the south can expect to live a larger proportion of their remaining lives hearing impaired. Although transitions from hearing impaired to unimpaired occur, those with some hearing impairment at age 50 can expect to live more years with hearing impairment, and hearing impairment does not shorten remaining life expectancy.

DISCUSSION

Significant sociodemographic disparities in hearing impaired life expectancy exist. In contrast to past research, we find that hearing impairment does not affect total life expectancy. Future research should consider the consequences of hearing impairment for years to be lived with other age-related and potentially downstream health outcomes.

Sudden deafness and tuning fork tests: towards optimal utilisation

The tuning fork tests have been under attack since their first use in clinical examination. However, the tuning fork is small and fits into every white coat, and tuning fork tests for hearing are easy, accurate and inexpensive. They should be used in patients with an acute unilateral hearing loss if an electric audiometer is not available. After more than 100 years, the tuning fork is not obsolete; tuning fork tests are very useful if used correctly and for the appropriate indication.