Testing the reliability and validity of the modified Amsterdam Inventory for Auditory Disability and Handicap in career firefighters in the United States

BACKGROUND

Firefighters are routinely exposed to loud noise that put them at risk for hearing loss. A reliable and valid measure to assess firefighters' hearing function is important. This study aims to test the reliability and validity of the modified Amsterdam Inventory for Auditory Disability and Handicap ((m)AIADH) in firefighters.

METHOD

A cross-sectional study was conducted using a convenience sample of 239 career firefighters from six partnered fire departments in Central Texas and Northern California. The internal consistency, convergent and criterion validity, and the ability to discriminate groups by measured hearing, perceived hearing, and a combination of measured and perceived hearing, were examined using the total score and score for each of the five subscales of the (m)AIADH.

RESULTS

The study participants were primarily men (93%). Satisfactory internal consistency was revealed for the (m)AIADH with Cronbach's alpha above 0.80 for all five subscales. Criterion analysis presented a moderate correlation between the (m)AIADH and the average of hearing threshold at high frequencies (4, 6, and 8 kHz). For convergent validity, the (m)AIADH was moderately to highly related with perceived hearing. There were statistically significant differences in the total (m)AIADH score and the five subscales for measured hearing thresholds except for "intelligibility in quiet." The (m)AIADH also showed a discriminative ability to distinguish between the group with good perceived hearing and the group with bad perceived hearing.

CONCLUSION

The (m)AIADH is a reliable and valid measure to assess various dimensions of hearing function among firefighters.

Surgical management of large cerebellopontine angle meningiomas: long-term results of a less aggressive resection strategy

OBJECTIVE

Cerebellopontine angle (CPA) meningiomas present many surgical challenges depending on their volume, site of dural attachment, and connection to surrounding neurovascular structures. Assuming that systematic radical resection of large CPA meningiomas carries a high risk of permanent morbidity, the authors adopted an alternative strategy of optimal resection followed by radiosurgery or careful observation of the residual tumor and assessed the efficiency and safety of this approach to meningioma treatment management.

METHODS

This single-center retrospective cohort study included 50 consecutive patients who underwent surgery for meningioma between January 2003 and February 2020.

RESULTS

The most common main dural attachments of the meningiomas were posterior (42%) and superior (26%) to the internal auditory meatus. The suboccipital retrosigmoid route was the most routinely used (92%). At the last follow-up examination, 93% of the patients with normal preoperative facial nerve (FN) function retained good House-Brackmann (HB) grades of I and II, whereas 3 patients (7%) displayed intermediate HB grade III FN function. Hearing preservation was achieved in 86% of the patients who presented with preoperative serviceable hearing, and recovery after surgery was achieved in 19% of the patients experiencing preoperative hearing loss. In order to preserve all cranial nerve function, gross-total resection was obtained in 26% of patients. Of the 35 patients who had undergone subtotal resection, 20 (57%) had been allocated into a wait-and-rescan treatment approach and 15 (43%) underwent upfront Gamma Knife surgery (GKS). The mean postoperative tumor volume was 1.20 cm3 in the upfront GKS group and 0.73 cm3 in the wait-and-rescan group (p = 0.08). Tumor control was achieved in 87% and 55% of cases (p < 0.001), with a mean follow-up of 85 and 69 months in the GKS and wait-and-rescan groups, respectively. The 1-, 5-, and 7-year tumor progression-free survival rates were 100%, 100%, and 89% in the GKS group and 95%, 59%, and 47% in the wait-and-rescan group, respectively (p < 0.001).

CONCLUSIONS

Optimal nonradical resection of large CPA meningiomas provides favorable long-term tumor control and functional preservation. Adjuvant GKS does not carry additional morbidity and appears to be an efficient adjuvant treatment.

Effect of Sound Coding Strategies on Music Perception with a Cochlear Implant

The goal of this study was to evaluate the music perception of cochlear implantees with two different sound processing strategies. Methods: Twenty-one patients with unilateral or bilateral cochlear implants (Oticon Medical®) were included. A music trial evaluated emotions (sad versus happy based on tempo and/or minor versus major modes) with three tests of increasing difficulty. This was followed by a test evaluating the perception of musical dissonances (marked out of 10). A novel sound processing strategy reducing spectral distortions (CrystalisXDP, Oticon Medical) was compared to the standard strategy (main peak interleaved sampling). Each strategy was used one week before the music trial. Results: Total music score was higher with CrystalisXDP than with the standard strategy. Nine patients (21%) categorized music above the random level (>5) on test 3 only based on mode with either of the strategies. In this group, CrystalisXDP improved the performances. For dissonance detection, 17 patients (40%) scored above random level with either of the strategies. In this group, CrystalisXDP did not improve the performances. Conclusions: CrystalisXDP, which enhances spectral cues, seemed to improve the categorization of happy versus sad music. Spectral cues could participate in musical emotions in cochlear implantees and improve the quality of musical perception.

[Clinical case for removal supralabyrinthine petrous bone cholesteatoma with improvement of hearing function]

The article presents the clinical case of supralabyrinthine petrous bone cholesteatoma. We have analyzed the preoperative examination of the patient for identification method of surgical treatment with preservation the facial nerve, improvement hearing function and reducing risk of recurrent cholesteatoma, perioperative findings and the end result of surgical treatment.

Comparison between overlay and underlay primary myringoplasty: retrospective analysis on anatomical and functional results in 497 adult patients

PURPOSE

Retro-auricular approach using an autologous graft is the main surgical method for myringoplasty (MPL). Endaural and transcanal or endoscopic approaches are also used. There is no definitive consensus on the best MPL surgical technique. The aim of this study is to compare the two most used technique, over and underlay MPL, to evaluate the difference in anatomical and functional outcomes.

MATERIALS AND METHODS

We made a retrospective analysis of 497 adult patients who underwent underlay or overlay primary MPL, between 2010 and 2018, and evaluated the difference in anatomical and functional outcomes.

RESULTS

Successful functional results, evaluated 18 months after surgery, were obtained in 380 patients (76,4%); the underlay MPL obtained a successful result in 85% of patients, while the overlay technique in the 68%. We observed anatomical failure in 13.4% patients, in detail 9,8% of underlay MPL and 17,2% of overlay MPL had an anatomical failure.

CONCLUSION

Our results show less complications related to the underlay technique. We believe that this remains the technique to prefer, except in subtotal or wide anterior perforations that could be better managed using the overlay technique.

Investigation of the Interaction between Hearing Function and Comorbidities in Adults Living with Human Immunodeficiency Virus

Adults living with the human immunodeficiency virus (HIV) have a high prevalence of co-existing comorbidities. While research indicates that adults living with HIV are at risk of developing hearing impairment, limited research exists on the interaction between hearing function and comorbidities in this population. The objective of this study was to determine and compare the hearing function of a group of adults living with HIV and comorbidities and those without comorbidities. A sample of 132 adults living with HIV underwent a basic audiological test battery to assess their hearing function. Participants with comorbidities were 1.23 times more likely to develop hearing loss, with crude odds of 1.236 (95%CI 0.5467 to 2.795), while those with three comorbidities were 2.52 times more likely to develop hearing loss. Participants with hypertension were 93% more likely to develop hearing loss when compared to nonhypertensive participants (OR = 1.928; 95%CI: 0.7856 to 4.7345). There was only a marginal association between hypercholesterolemia and sensorineural hearing loss (SNHL), with no association between other comorbidities and the type of hearing loss. The current findings raise a need for prioritizing patients with comorbidities in audiological assessment and monitoring in resource-constrained contexts, where capacity versus demand challenges might prevent the provision of audiological services to all adults living with HIV. These findings also highlight the importance of preventive care in this population with regard to the burden of the disease, as it may lead to worse ear and hearing outcomes for affected individuals.

Clinical Trial for Cartilage Conduction Hearing Aid in Indonesia

Hearing improvement represents one of the may valuable outcomes in microtia and aural atresia reconstruction surgery. Most patients with poor development in their hearing function have had a severe microtia. Conventional methods to improve hearing function are bone conduction and bone anchored hearing aids. Cartilage conduction hearing aids (CCHA) represents a new amplification method. This study assessed the outcomes and evaluated the impact and its safety in the patients with microtia and aural atresia whose hearing dysfunction did not improve after surgery for ear reconstruction in our hospital. Hearing functions were evaluated with pure tone audiometry or sound field testing by behavioral audiometry and speech audiometry before and after CCHA fitting. As a result, there was a significant difference between unaided and aided thresholds (p < 0.001). Speech recognition threshold and speech discrimination level also significantly improved with CCHA. The average functional gains of 14 ears were 26.9 ± 2.3 dB. Almost all parents of the patients reported satisfaction with the performance of CCHA, and daily communication in children with hearing loss also became better than usual.

The role of cGMP signalling in auditory processing in health and disease

cGMP is generated by the cGMP-forming guanylyl cyclases (GCs), the intracellular nitric oxide (NO)-sensitive (soluble) guanylyl cyclase (sGC) and transmembrane GC (e.g. GC-A and GC-B). In summarizing the particular role of cGMP signalling for hearing, we show that GC generally do not interfere significantly with basic hearing function but rather sustain a healthy state for proper temporal coding, fast discrimination and adjustments during injury. sGC is critical for the integrity of the first synapse in the ascending auditory pathway, the inner hair cell synapse. GC-A promotes hair cell stability under stressful conditions such as acoustic trauma or ageing. GC-B plays a role in the development of efferent feed-back and gain control. Regarding the crucial role hearing has for language development, speech discrimination and cognitive brain functions, differential pharmaceutical targeting of GCs offers therapeutic promise for the restoration of hearing.

Evaluation of cochlear involvement and hearing function in lipoid proteinosis patients

BACKGROUND

Lipoid proteinosis (LP) is a rare genodermatosis involving amorphous hyaline accumulation in the skin, oral mucosa, larynx, mucous membranes, and viscera.

AIMS

In this study, we aimed to investigate the effects of hyaline accumulation on cochlear function and hearing in LP patients.

PATIENTS/METHODS

In this prospective study, 20 patients who were followed up with a diagnosis of LP between October 2016 and April 2020 in our clinic and 20 healthy individuals of the same age and gender, as a control group, were included. Pure-tone audiometry, tympanometry, and distortion-product otoacoustic emission tests of the patient and control groups were performed. The audiological results of the LP and control groups were compared statistically.

RESULTS

In the comparison of air-conduction thresholds between groups in pure-tone audiometry, hearing thresholds in the patient group were found to be higher than the control group at frequencies of 250, 4000, 6000, and 8000 Hz for the right ear, and 500 and 4000 Hz for the left ear. In the comparison of signal-noise responses between groups in distortion-product otoacoustic emission (DP-OAE) test, signal-noise responses in the right and left ear at frequencies of 1000, 2000, 4000, and 6000 Hz were lower in the patient group than in the control group.

CONCLUSION

We found that the cochlear functions of patients with LP were affected due to the increase in hearing thresholds and decreased signal-noise responses. We think that LP patients are candidates for hearing loss in their later life.

Decline in prevalence of congenital sensorineural deafness in Dalmatian dogs in the United Kingdom

Background

Congenital sensorineural deafness (CSD) is the most common type of deafness in Dalmatian dogs.

Objectives

To use results of CSD screening in Dalmatian dogs in the United Kingdom in genetic analysis and to determine any changes in the prevalence of CSD in this breed over time.

Animals

A total of 8955 Dalmatian puppies undergoing hearing function screening using brainstem auditory evoked response (BAER) between July 1992 and February 2019.

Methods

Results of BAER testing and pigmentation phenotypic data were linked to the UK Kennel Club Dalmatian pedigree database. Mixed model analysis was used to estimate variance parameters.

Results

The overall prevalence of CSD was 17.8% (13.4%, unilateral; 4.4%, bilateral). Heritability of CSD was approximately 0.3 (across models) and significantly >0. Genetic correlations between CSD and blue irises (+0.6) and pigmented head patch (−0.86) were large in magnitude and significantly different form 0. Significant improving phenotypic and genetic trends were identified, likely as the result of selection against deafness, equivalent to avoiding breeding with the 4% to 5% of animals with the highest genetic risk of CSD.

Conclusions and Clinical Importance

A decrease in the prevalence and genetic risk of CSD implies breeders have been selecting for hearing dogs. Selective breeding based on estimated breeding values (EBVs) can help further decrease the prevalence of CSD in Dalmatians in the future.

[Audiological profile of patients with SARS-Co-V-2 PCR-positive cases]

COVID-19 is a new pandemic caused by a novel coronavirus, SARS-CoV-2. COVID-19 has spread throughout China and received worldwide attention. On 11 February 2020, World Health Organization (WHO) officially declared COVID-19. The clinical symptoms of COVID-19 patients may vary, more often include symptoms affected by upper and lower respiratory tract damage. In ENT practice it is used to mention rhinitis, sore throat, anosmia/hyposmia. The effect of COVID-19 is an interesting issue in audiology. There were 78 patients who were confirmed positive for COVID-19 PCR-positive cases and 30 normal non-infected subjects in our study. The patients were divided into two groups according to severity their clinical symptoms from asymptomatic COVID-19 PCR-positive cases to severe form. All patients underwent audiological evaluation included tympanometry, acoustic threshold and transient evoked otoacoustic emission (TEOAE). Although hearing sensitivity was normal among some participants, it was statistically proved that TEOAEs could pick up subtle deterioration in the outer hair cells functions and impact on the cochlear.

Superparamagnetic Nanoparticle Delivery to the Cochlea Through Round Window by External Magnetic Field: Feasibility and Toxicity

Introduction. The objective of this study was to evaluate the feasibility and toxicity of superparamagnetic iron oxide nanoparticles (SPIONs) administered into the cochlea through the round window (RW) by an external magnetic field. Materials and Methods. In 5 Wistar rats, the left RW was punctured. SPIONs suspended in hyaluronic gel (5 mg/mL) were applied in the RW niche and covered by a muscle graft. The nanoparticles were mobilized using a rare earth magnet (0.54 T) held in 4 consecutive positions around the head. The right ear served as control. Hearing function was monitored by auditory brainstem responses (4-32 kHz tone bursts). Results. The auditory thresholds remained unchanged 1 month after the administration. The histological study of the cochleae showed that SPIONs were driven into the scala tympani in the basal turn, the second turn, and the apex. Conclusion. Superparamagnetic nanoparticles can be driven inside the cochlea toward the apex with a preserved hearing up to 1 month in rats.

Relationship between changes in hearing function and volumes of endolymphatic hydrops after endolymphatic sac drainage

Background: Endolymphatic sac drainage (ELSD) may have a positive effect on endolymphatic hydrops (EH) and may help to preserve inner ear function. However, the relationship between changes in EH volumes and hearing function after ELSD has not been described. Objectives: We aimed to reveal the factors related to changes in hearing and EH following ELSD. Material and Methods: Twenty-one patients who received ELSD were enrolled. Pure tone audiometry and 3-T magnetic resonance imaging (MRI) 4 h after intravenous injection of gadolinium enhancement were performed just before surgery and 2 years later. To characterize the endolymphatic space (ELS), we measured the volume of the total fluid (TFS) and ELS and calculated the ratio of ELS to TFS (ELS ratio). Results: The ELS ratio of the patients who showed hearing improvement was 18.5 ± 11.4% before surgery and 23.9 ± 14.3% after. For those with no change, it was 29.7 ± 10.8% before and 29.4 ± 9.5% after, and in patients with worsened hearing function it was 22.7 ± 7.5% before and 27.2 ± 13.4% after. Conclusion: We found no correlation between the changes in hearing function and the volume of EH after ELSD.

Age-Related Differences in Hearing Function and Cochlear Morphology between Male and Female Fischer 344 Rats

Fischer 344 (F344) rats represent a strain that is frequently used as a model for fast aging. In this study, we systematically compare the hearing function during aging in male and female F344 rats, by recording auditory brainstem responses (ABRs) and distortion product otoacoustic emissions (DPOAEs). In addition to this, the functional parameters are correlated with the cochlear histology. The parameters of the hearing function were not different in the young (3-month-old) male and female F344 rats; the gender differences occurred only in adult and aged animals. In 8–24-month-old males, the ABR thresholds were higher and the ABR amplitudes were smaller than those measured in females of the same age. There were no gender differences in the neural adaptation tested by recording ABRs, elicited by a series of clicks with varying inter-click interval (ICI). Amplitudes of DPOAEs in both the males and females decreased with age, but in the males, the decrease of DPOAE amplitudes was faster. In males older than 20 months, the DPOAEs were practically absent, whereas in 20–24-month-old females, the DPOAEs were still measurable. There were no gender differences in the number of surviving outer hair cells (OHC) and the number of inner hair cell ribbon synapses in aged animals. The main difference was found in the stria vascularis (SV). Whereas the SV was well preserved in females up to the age of 24 months, in most of the age-matched males the SV was evidently deteriorated. The results demonstrate more pronounced age-related changes in the cochlear morphology, hearing thresholds, ABR amplitudes and DPOAE amplitudes in F344 males compared with females.

Ick Ciliary Kinase Is Essential for Planar Cell Polarity Formation in Inner Ear Hair Cells and Hearing Function

Cellular asymmetries play crucial roles in development and organ function. The planar cell polarity (PCP) signaling pathway is involved in the establishment of cellular asymmetry within the plane of a cell sheet. Inner ear sensory hair cells (HCs), which have several rows of staircase-like stereocilia and one kinocilium located at the vertex of the stereocilia protruding from the apical surface of each HC, exhibit a typical form of PCP. Although connections between cilia and PCP signaling in vertebrate development have been reported, their precise nature is not well understood. During inner ear development, several ciliary proteins are known to play a role in PCP formation. In the current study, we investigated a functional role for intestinal cell kinase (Ick), which regulates intraflagellar transport (IFT) at the tip of cilia, in the mouse inner ear. A lack of Ick in the developing inner ear resulted in PCP defects in the cochlea, including misorientation or misshaping of stereocilia and aberrant localization of the kinocilium and basal body in the apical and middle turns, leading to auditory dysfunction. We also observed abnormal ciliary localization of Ift88 in both HCs and supporting cells. Together, our results show that Ick ciliary kinase is essential for PCP formation in inner ear HCs, suggesting that ciliary transport regulation is important for PCP signaling.SIGNIFICANCE STATEMENT The cochlea in the inner ear is the hearing organ. Planar cell polarity (PCP) in hair cells (HCs) in the cochlea is essential for mechanotransduction and refers to the asymmetric structure consisting of stereociliary bundles and the kinocilium on the apical surface of the cell body. We reported previously that a ciliary kinase, Ick, regulates intraflagellar transport (IFT). Here, we found that loss of Ick leads to abnormal localization of the IFT component in kinocilia, PCP defects in HCs, and hearing dysfunction. Our study defines the association of ciliary transport regulation with PCP formation in HCs and hearing function.

Hearing function after intratympanic application of gadolinium-based contrast agent: A long-term evaluation

OBJECTIVES/HYPOTHESIS

The aim of this study was to evaluate the long-term influence of intratympanic gadolinium-based contrast agent on hearing function in patients with possible Ménière's disease and normal auditory thresholds who were undergoing locally enhanced magnetic resonance imaging scans.

STUDY DESIGN

Prospective observational cohort study in a tertiary referral university hospital ear, nose, and throat department.

METHODS

Between 2009 and 2012, 17 patients with possible or probable Ménière's disease and a four-tone pure-tone average baseline of <25 dB were recruited for our study. Before undergoing intratympanic injection of gadolinium-based contrast agent, all patients underwent a complete audiological evaluation. The study population was then invited back after at least 6 months postinjection for a follow-up auditory evaluation. This consisted of comprehensive clinical and audiological tests on both sides and were evaluated according to the ototoxicity guidelines.

RESULTS

A long-term evaluation of our study group revealed no significant difference in the air-conduction pure-tone average. Furthermore, no statistical difference at individual frequencies compared to baseline was found. There was no evidence of ototoxicity in the injected ear.

CONCLUSIONS

Long-term hearing function assessment after intratympanic application of gadolinium-based agent showed no evidence of ototoxicity. The use of intratympanic gadolinium-based agent in the diagnosis of Ménièrés disease is currently a helpful tool, and seems to be a safe method, especially with regard to auditory function.

LEVEL OF EVIDENCE

4.

Relationship between changes in the cochlear blood flow and disorder of hearing function induced by blast injury in guinea pigs

The auditory system is the most susceptible to damages from blast waves. Blast injuries always lead to varying degrees of hearing impairment. Although a disorder of the cochlear blood flow (CoBF) has been considered to be related to many pathological processes of the auditory system and to contribute to various types of hearing loss, changes in the CoBF induced by blast waves and the relationship between such changes and hearing impairment are undefined. To observe the changes in the cochlear microcirculation after exposure to an explosion blast, investigate the relationship between changes in the CoBF and hearing impairment and subsequently explore the mechanism responsible for the changes in the CoBF, we detected the perfusion of the cochlear microcirculation and hearing threshold shift after exposure to an explosion blast. Then, an N-nitro-L-arginine-methyl ester (L-NAME, NO synthase inhibitor) solution and artificial perilymph were applied to the round window (RW) of the cochlea before the blast exposure, followed by an evaluation of the CoBF and hearing function. The results indicated that the changes in the CoBF were correlated to the strength of the blast wave. The cochlear blood flow significantly increased when the peak value of the blast overpressure was greater than approximately 45 kPa, and there was no significant change in the cochlear blood flow when the peak value of the blast overpressure was less than approximately 35 kPa. Following local administration of the NO synthase inhibitor L-NAME, the increase in the CoBF induced by the blast was inhibited, and this reduction was significantly associated with the hearing threshold.