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PubMed2000

Bilateral sensorineural hearing disorders in children: etiology of deafness and evaluation of hearing tests.

OBJECTIVE: The purpose of this study was to determine the etiology of bilateral sensorineural hearing disorders in children and to evaluate the performed hearing tests by comparison of the results of the objective and subjective tests. METHODS: The medical history and the hearing tests (behavioral observation audiometry, acoustic evoked potentials and pure tone audiometry) of 106 bilaterally hearing impaired children were analyzed in a retrospective follow-up study. RESULTS: The total group included 52 males and 54 females. The ages at first diagnosis ranged from 4 months to 11 years with a mean age of 42 months and a median of 33 months. The degree of hearing loss for the better hearing ear was mild in one child, moderate in 28 children, severe in 29 children, profound in 32 children and total in 16 children. The delay between the first examination and diagnosis ranged from 0 to 597 days with a mean of 83 days and a median of 28 days. In 47 children (44%) no cause of hearing impairment could be determined. Nineteen children (18%) had a history of familial hearing loss, 40 (38%) suffered from acquired hearing loss (seven children had prenatal causes, 21 perinatal and 12 postnatal). A comparison between behavioral observation audiometry and brainstem evoked response audiometry revealed a statistically good agreement. Twenty-nine children (32%) showed progressive hearing loss, which was defined as a threshold shift of +10 dB or more in the pure tone average in at least one ear. CONCLUSIONS: In a significant number of children with early hearing impairments the etiology still remains uncertain. Further research in the field of genetic disorders will diminish this number. Evaluation of hearing tests showed that behavioral observation audiometry still is an excellent tool in the hands of an experienced examiner. The age at identification of hearing disorders in industrialized countries still is unacceptably high. To obtain ideal care of hearing impaired children, universal neonatal hearing screening programs are mandatory.

Age Distribution↗
PubMed1990

Effect of noise on word discrimination by subjects with impaired hearing, compared with those with normal hearing.

A comparison was made of the discrimination ability of different groups of hearing-impaired and normal-hearing subjects in noisy conditions. Four groups of subjects having a sensorineural hearing loss with various audiogram configurations, one group of subjects having a conductive hearing loss and one group of normal-hearing subjects were chosen. The submaster tapes were recorded in quiet and in pink noise with signal-to-noise ratios of -3, -8, and -13 dB. The test subjects heard the test words monaurally via earphones. The best speech discrimination was achieved in quiet, anechoic conditions. As the noise level increased, speech discrimination decreased. Subjects with sensorineural hearing loss were more adversely affected by noise than subjects with normal hearing or with conductive hearing loss. However, at high noise levels, their speech discrimination was poorer than that of normal-hearing subjects. Persons with a high-frequency hearing loss, cut-off point 1 kHz, suffered in noise similarly to those with sloping or flat hearing losses. In quiet and in moderate noise, the speech discrimination of subjects with a conductive hearing loss and subjects with normal hearing was similar, while at high noise levels, subjects with conductive hearing losses achieved better discrimination than normal-hearing subjects.

Adolescent↗
PubMed2001

Outcomes and patient-based hearing status in conductive hearing loss.

OBJECTIVES/HYPOTHESIS: To study hearing status and quality of life outcomes in patients with conductive hearing loss (CHL), and to develop a prognostic disease severity staging system for use in future clinical outcomes studies in CHL. STUDY DESIGN: Clinical outcomes research study in three stages: 1) Prospective development and psychometric validation of a disease-specific hearing status outcomes instrument for CHL. 2) Prospective observational outcomes study of patient-based hearing status and quality of life (QOL) outcomes after treatment of CHL. 3) Development of a prognostic disease-severity staging system to stratify patients into groups of similar treatment outcome. METHODS: Psychometric instrument validation: assessment of test-retest reliability, internal consistency reliability, content, construct and criterion validity, and responsiveness to change. Statistical assessment of the impact of CHL on patient-based hearing status and QOL, and the change in hearing status and QOL after treatment. Using data from the prospective study and multivariate regression, identification of pretreatment independent variables, which predict good outcome after treatment, and development of a severity staging system. RESULTS: Test-retest reliability (r >0.70) and internal consistency reliability (alpha >0.70) were adequate for both subscales of the hearing status instrument. Construct validity was demonstrated by adequate convergent/divergent validity with other health status instruments on multi-item multitrait correlation matrixes. Criterion validity was demonstrated using audiometric threshold data. Responsiveness to change was demonstrated using the standardized response mean after treatment (SRM = 0.40 and 0.61 for the two subscales). Emotional hearing status and social/situational hearing status improved significantly after treatment of CHL: emotional score, 31.1 to 56.6 (P < .001); social/situational score, 56.7 to 63.7 (P = .01). Mean QOL subscale scores for patients with CHL were not significantly different from healthy populations, and global QOL scores did not change significantly after treatment of CHL. Using proportional improvement in emotional hearing status as an outcome, we identified several pretreatment factors that predicted good outcome (i.e., larger proportional improvement): level of pretreatment emotional hearing status, presence of sensorineural component of HL, and etiology of CHL (otosclerosis vs. all other causes). Some hypothesized predictive independent factors, such as bilateral HL, audiometric threshold level, pretreatment functional status, employment status, age, and duration of HL, were not identified as significant predictors of outcome in the multivariate analysis. We constructed a prognostic disease severity staging system in which the three predictor variables were each given a score of 0 or 1, and these three scores were added to obtain the disease stage (stage 0, 1, 2, or 3). Higher disease stage indicated more severe disease or a lower proportional improvement in emotional hearing status after treatment. This staging system appropriately stratified patients into groups of similar outcome after treatment (P = .02) and has significant potential use for future outcomes research on CHL. CONCLUSIONS: We have developed and validated a patient-based hearing status outcomes instrument for use in CHL. We have measured hearing status and quality of life outcomes after treatment of CHL, and we have developed a prognostic disease severity staging system that predicts the improvement in emotional hearing status after treatment of CHL.

Adaptation, Physiological↗
PubMed1997

[Progressive hearing loss in children with hearing aids].

BACKGROUND: The possibility of hearing aid induced deterioration was first described in 1939 (Berry 1939, Holmgren 1939). Since then numerous studies discussed this problem controversely. However, it is undisputed that in cases of profound sensorineural hearing loss in childhood powerful hearing aids are necessary for maturation and auditory and speech development. An increase of progressive sensorineural hearing loss in the last three years in children with profound sensorineural hearing loss fitted with hearing aids (2 children in 1993, 6 children in 1996) drew our attention to this problem. METHOD: Over a period of four years, we collected the data of 16 children with progressive hearing loss. RESULTS: The comparison of the duration of the hearing aid use since fitting and the maximum output level fail to explain this increase. Moreover our strategy in hearing aid fitting remained unchanged during this period especially with regard to SSPL max. We also performed an analysis of the childhood disorders associated with the sensorineural hearing losses. This analysis provided no further information for the increase of hearing loss. CONCLUSION: There is no evidence that powerful hearing aids damage hearing and induce progressive sensorineural hearing loss in childhood. Therefore we believe that there is no need to change our hearing aid fitting strategy particularly with regard to the maximum output level up to 135 dB SPL measured in situ. The increase in the number of progressive cases in the last two years indicates the necessity of further investigations in this field.

Child↗
PubMed2006

Speech recognition in normal hearing and sensorineural hearing loss as a function of the number of spectral channels.

Speech recognition by normal-hearing listeners improves as a function of the number of spectral channels when tested with a noiseband vocoder simulating cochlear implant signal processing. Speech recognition by the best cochlear implant users, however, saturates around eight channels and does not improve when more electrodes are activated, presumably due to reduced frequency selectivity caused by channel interactions. Listeners with sensorineural hearing loss may also have reduced frequency selectivity due to cochlear damage and the resulting reduction in the nonlinear cochlear mechanisms. The present study investigates whether such a limitation in spectral information transmission would be observed with hearing-impaired listeners, similar to implant users. To test the hypothesis, hearing-impaired subjects were selected from a population of patients with moderate hearing loss of cochlear origin, where the frequency selectivity would be expected to be poorer compared to normal hearing. Hearing-impaired subjects were tested for vowel and consonant recognition in steady-state background noise of varying levels using a noiseband vocoder and as a function of the number of spectral channels. For comparison, normal-hearing subjects were tested with the same stimuli at different presentation levels. In quiet and low background noise, performance by normal-hearing and hearing-impaired subjects was similar. In higher background noise, performance by hearing-impaired subjects saturated around eight channels, while performance by normal-hearing subjects continued to increase up to 12-16 channels with vowels, and 10-12 channels with consonants. A similar trend was observed for most of the presentation levels at which the normal-hearing subjects were tested. Therefore, it is unlikely that the effects observed with hearing-impaired subjects were due to insufficient audibility or high presentation levels. Consequently, the results with hearing-impaired subjects were similar to previous results obtained with implant users, but only for background noise conditions.

Adult↗
PubMed1998

Effect of hyperbaric oxygen therapy in comparison to conventional or placebo therapy or no treatment in idiopathic sudden hearing loss, acoustic trauma, noise-induced hearing loss and tinnitus. A literature survey.

With the published clinical data to hand on the therapeutic results of patients with idiopathic sudden hearing loss, acoustic trauma or noise-induced hearing loss, it may be confirmed that 65% of those polypragmatically treated patients demonstrated a hearing improvement of 19 +/- 4 dB. In 35% of the cases, no hearing improvement was detected independent of the drugs administered. This corresponds to the results obtained from placebo-treated patients who demonstrated a hearing improvement of 20 +/- 2 dB in 61% of cases and no hearing gain in 39% of cases (fig. 1). A different set of results was obtained from patients with a hearing loss who were treated either with prednisolone or placebo. The percentage of patients who achieved normal hearing again in the placebo-treated group amounted to 31% and 38% and in the verum-treated group 50% and 78%. It may be concluded that a placebo therapy is equally effective to that of all nonsteroidal drugs. Problems arise when comparing non-treated patients since information on spontaneous remission rates differs greatly in the references, i.e. between 25-68% for spontaneous full remissions and 47-89% for spontaneous partial remissions. From a statistical view, 35% and 39% of patients experienced no success with nonsteroidal drugs or placebo, respectively. These patients can still be helped with HBO therapy. 18 patients only underwent primary HBO therapy. In all other 50 studies evaluated here with a total of 4, 109 patients suffering from idiopathic sudden hearing loss, acoustic trauma or noise-induced hearing loss and/or tinnitus, HBO therapy was administered as a secondary therapy, i.e. following unsuccessful conventional therapy. If the onset of affliction was more than 2 weeks but no longer than 6 weeks, one half of the cases showed a marked hearing gain (in at least 3 frequencies of more than 20 dB), one-third showed a moderate improvement (10-20 dB) and 13% showed no hearing improvement at all (fig. 2). 4% no longer experienced tinnitus, 81.3% observed an intensity decrease and 1.2% an intensity increase of their tinnitus condition. 13.5% remained unchanged (fig. 2). If HBO therapy was administered at a later stage, but still within 3 months following onset of affliction, 13% showed a definite improvement in hearing, 25% a moderate improvement and 62% no improvement at all. 7% no longer suffered from tinnitus, 44% reported an intensity decrease, a similar percentage noticed no change and 5% a temporary deterioration of their tinnitus condition. If the onset of affliction was longer than 3 months up to several years, no hearing improvement can be expected in the majority of patients (fig. 3); however, one third of the cases reported an intensity decrease of tinnitus, 60-62% reported no change and 4-7% noticed a temporary intensity increase (fig. 4). In conclusion, it may be deduced that HBO therapy is recommended and warranted in those patients with idiopathic sudden deafness, acoustic trauma or noise-induced hearing loss within 3 months after onset of disorder.

Clinical Trials as Topic↗
PubMed1996

[Relationship between distortion product otoacoustic emissions and frequency discrimination in normal-hearing and hearing-impaired ears].

Distortion product otoacoustic emissions (DPOAEs) and frequency difference limens (FDLs) were recorded in each of 10 ears with a sensorineural hearing loss of the dip-type and with sharp-cut high frequency hearing loss. DPOAEs were recorded with an Otodynamic Analyser ILO92 (ver. 1.35) at a f2/f1 frequency ratio 1.2. The distortion-product level (DP level) at 2f1-f2 was measured at 11 points at f2 frequencies between 696 Hz and 6348 Hz and at 26 points at f2 frequencies between 708 Hz and 6165 Hz in the dip-typed and the sharp-cut high frequency hearing loss patients, respectively. The stimulus intensity of primaries was fixed at 70 dBSPL at L and 60 dBSPL at L2. Graphs of DP levels versus f2 frequency (DP-gram) were plotted. FDLs were measured to use "same" or "different" method. Estimates of FDL were obtained at the same frequencies at 11 points from 696 Hz to 6348 Hz as f2 of DPOAE and at sensation levels from 25 dB to 35 dB. As a control, DPOAEs and FDLs were measured in 30 and 50 normal young adults, respectively. The following results ane conclusions were obtained: 1. The DP-gram obtained from 30 normal-hearing ears showed two peaks, at around 1.5 kHz and 5 kHz. 2. DP-grams were similar to Békésy audiograms in frequency specificity in 20 hearing-impaired ears. 3. DP-grams with a f2 abscissa were more similar in shape to Békésy audiograms than DP-grams with a (f1 x f2)1/2 abscissa. 4. The FDLs obtained in 50 normal-hearing ears showed an approximately linear increase in log delta F versus logarithmic frequency of stimuli up to 5 kHz. 5. FDLs at the DPOAE frequencies below the noise level in 20 hearing-impaired ears were greater than two standard deviations from the value for normal-hearing ears. 6. A significant correlation between DPOAEs and hearing threshold levels (HTLs) was found in the 20 ears of the hearing impaired. 7. Significant correlations between DPOAEs and FDL ratios (FDLs in hearing-impaired ears divided by FDLs in normal-hearing ears) were found in these 20 ears, although the correlation coefficient was not as high in the 10 ears with a sharp-cut high frequency hearing loss as in the 10 ears with the dip-typed hearing loss. These results suggested that DPOAEs might serve as an objective indicator of frequency discrimination. Care should be taken, however not to generalize this suggestion to all kinds of hearing loss patients.

Adult↗
PubMed1990

[A study of the relationship between hearing-aid usage and residual hearing].

Fifty-eight children (from 4 to 19 years of age) with bilateral, symmetrical, sensorineural hearing loss, who had used a hearing aid in only one ear for 1 to 19 years were investigated to study the influence of hearing-aid upon the residual hearing between the used and no used ears. The results were as follows, 1) The average hearing level for the used ear at seven frequencies was 49. 5 dB of pre-hearing-aid usage and was 53. 8 dB of post-hearing-aid usage. The discrepancy of audiograms between the aided and unaided ear was not remarkable. 2) The hearings for both the aided and the unaided ears in Audiograms was progressive for a long time. But no significance relation was observed between changes in used-ear hearing of the aided and unaided ears. 3) When the hearing levels of the children were scrutinised on an individual basis, it was found that 9 cases (15.5%) in both ears, 2 cases (3.4%) in only used ear and 1 case (1.7%) in only no used ear out of 58 cases showed deterioration of hearing. 4) These data did not lead us to the conclusion that hearing-aid usage was detrimental on the residual hearing of children with sensorineural hearing loss.

Adolescent↗
PubMed2003

Audibility-index predictions of normal-hearing and hearing-impaired listeners' performance on the connected speech test.

OBJECTIVE: In a previous study (Sherbecoe & Studebaker, 2002), we derived a frequency-importance function and a transfer function for the audio compact disc version of the Connected Speech Test (CST). The current investigation evaluated the validity of these audibility-index (AI) functions based on how well they predicted data from four published studies that presented the CST to normal-hearing and hearing-impaired subjects. DESIGN: AI values were calculated for the test conditions received by 78 normal-hearing and 72 hearing-impaired subjects from the selected studies. The observed CST scores and AI values for these conditions/subjects were then plotted and the dispersion of the data compared to the expected range based on critical differences. The AI values for the conditions/subjects were also converted into expected CST scores and subtracted from their corresponding observed scores to determine the distribution of the resulting difference scores and the relationship between the difference scores and subject age. RESULTS: Good predictions were obtained for normal-hearing subjects who had been tested under audio-only conditions but not those who had received audiovisual tests. The expected scores for the latter subjects were too low when the AI accounted only for audibility and too high when it included the correction for visual cues from ANSI S3.5-1997. All of the hearing-impaired subjects had been tested under audio-only conditions. In their case, the mean difference between the observed and the expected scores was comparable with the audio-only mean for the normal-hearing subjects when the AI included corrections for speech level distortion and hearing loss desensitization. However, the hearing-impaired subject data had greater variability. The predictions for these subjects also decreased in accuracy when subject age increased beyond 70 yr despite the application of an AI correction for age. CONCLUSIONS: The results of this study suggest that the AI functions derived for the CST satisfactorily predict the scores of normal-hearing subjects when they listen in speech babble under audio-only conditions but not when they receive visual cues. To obtain accurate predictions for the audiovisual form of the CST, it will be necessary to develop new ANSI-style AI correction equations for visual cues or new AI functions based on audiovisual test scores. If the current AI functions are used to predict the scores of hearing-impaired listeners tested under audio-only conditions, the AI should include corrections for the effects of speech level and hearing loss. A correction for subject age also could be applied, if it seems appropriate to do so. In either case, however, the predictions are still likely to be less accurate than the predictions for normal-hearing subjects. This may be because speech recognition deficits in people with hearing loss are not due solely to diminished audibility. Hearing-impaired subjects, particularly if they are elderly, also may be more susceptible to masking effects or other factors not accounted for by the AI.

Adolescent↗
PubMed2005

Prelexical vocalization in normal hearing and hearing-impaired infants before and after cochlear implantation and its relation to early auditory skills.

OBJECTIVES: To compare the vocalizations of hearing-impaired infants before and after cochlear implantation with those of a control group of hearing infants and to relate prelexical vocalizations by using the PRoduction Infant Scale Evaluation (PRISE) to early auditory skill attainments, using the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) in normal-hearing and hearing-impaired (HI) infants before and after cochlear implantation. DESIGN: A total of 187 infants participated in the study: 24 HI infants with severe-profound hearing loss (8 to 23 months of age) and 163 hearing infants (0.5 to 20 months of age). Prelexical vocalizations and early auditory skills were assessed by using parent questionnaires (PRISE and IT-MAIS, respectively) that reflect known milestones in the infant's vocal and auditory development. HI infant data were compared with hearing infant data according to chronological age and duration of device use (hearing aid or cochlear implant). RESULTS: Average PRISE score of aided HI infants before implantation was 50% or less (regardless of age). This score is comparable to that of hearing infants who are 6 to 7 months of age. After implantation, HI infants reached a score of 70% but did not reach normative performance. When HI infant data were compared with hearing infants by duration of device use, aided infants before implantation performed as well or worse than normative performance, whereas implanted infants performed as well as or better than hearing infants. Performance on individual PRISE questions showed limited ability by HI infants before implantation compared with hearing and implanted infants. A strong correlation was found between the IT-MAIS and the PRISE (r = 0.93 and r = 0.83, for hearing and HI infants, respectively). CONCLUSIONS: The PRISE was found to be a versatile tool for implant team clinicians who are required to assess prelinguistic skills of infants. The findings suggest that early auditory skills are related to prelexical vocalization. The data also highlighted unanswered questions related to the importance of early fitting of hearing aids on vocalization before and after implantation.

Auditory Perception↗
PubMed2005

Spoken word recognition development in children with residual hearing using cochlear implants and hearing AIDS in opposite ears.

OBJECTIVE: With broadening candidacy criteria for cochlear implantation, a greater number of pediatric candidates have usable residual hearing in their nonimplanted ears. This population potentially stands to benefit from continued use of conventional amplification in their nonimplanted ears. The purposes of this investigation were to evaluate whether children with residual hearing in their nonimplanted ears benefit from bilateral use of cochlear implants and hearing aids and to investigate the time course of adaptation to combined use of the devices together. DESIGN: Pediatric cochlear implant recipients with severe sensorineural hearing loss in their nonimplanted ears served as participants. Ten children continued to use hearing aids in their nonimplanted ears after cochlear implantation; 12 children used their cochlear implants exclusively. Participants were tested longitudinally on spoken word recognition measures at 6-month intervals. The children who continued wearing hearing aids were tested in three sensory aid conditions: cochlear implants alone, hearing aids alone, and cochlear implants in conjunction with hearing aids. The children who did not continue hearing aid use were tested after surgery in their only aided condition, cochlear implant alone. RESULTS: The results suggest that children with severe hearing loss who continued using hearing aids in their nonimplanted ears benefited from combining the acoustic input received from a hearing aid with the input received from a cochlear implant, particularly in background noise. However, this benefit emerged with experience. CONCLUSIONS: Our findings suggest that it is appropriate to encourage pediatric cochlear implant recipients with severe hearing loss to continue wearing an appropriately fitted hearing aid in the nonimplanted ear to maximally benefit from bilateral stimulation.

Adaptation, Physiological↗
PubMed2001

[Status of hearing aid use by children in schools for the hearing impaired and deaf].

To evaluate and possibly improve the hearing aid fittings of children attending the Westphalian School for the Hearing Impaired or the Westphalian School for the Deaf, regular pedaudiologic consulting hours were established at both schools. During a 2-year period, 115 children were examined once, 35 children twice, and 5 children three times. The examinations comprised ear microscopy, audiometry, and a check of the hearing aids with a 0.6-cm3 coupler (children up to 7 years) or 2-cm3 coupler, respectively. The following criteria were used to assess the quality of the hearing aid setting: status of the external auditory canal and middle ear, acceptance of wearing the hearing aid, status of the ear mold, technical status of the hearing aid, and its setting. The results were related to four variables: gender, type of school, age, and mean hearing loss. Overall, just 40.9% of all children showed satisfactory hearing aid performance at the first examination and just 37.1% at the second. A significant influence of the variables on the hearing aid performance was documented for hearing loss only. The higher the hearing loss, the more likely the children were to have good hearing aid status. Analysis of the different parameters revealed that an incorrect setting was the main problem, with a rate of 20.9%; the rate of the other parameters varied from 6.1% to 15.7%. Thus, no parameter was of major relevance to the results. The results of the second examination were poorer in most parameters than those of the first. These alarming results, which are probably not only of regional significance, demonstrate that the hearing aid status of children attending schools for the hearing impaired or for the deaf is in urgent need of improvement.

Adolescent↗
PubMed1983

Airflow characteristics of fricative consonants produced by normally hearing and hearing-impaired speakers.

The purpose of this study was to investigate the rates of airflow for fricative consonants produced by normally hearing speakers and by hearing-impaired speakers who varied in degree of hearing loss and speech intelligibility. Subjects consisted of 20 normally hearing adults (10 men and 10 women), 20 moderately-to-severely hearing-impaired adults with intelligible speech (10 men and 10 women), and 20 profoundly hearing-impaired adults with semi-intelligible speech (10 men and 10 women). Average airflow rates were obtained for the fricatives /s/, /z/, /f/, and /v/ in CV and VCV syllables. In general, it was found that normally hearing, intelligible hearing-impaired, and some semi-intelligible hearing-impaired speakers produced voiceless fricatives with substantially greater airflow rates than they produced voiced cognates. The data also revealed that both male and female semi-intelligible hearing-impaired speakers produced fricatives in the CV context with greater amounts of airflow and fricatives in the VCV environment with less airflow than did the normally hearing and intelligible hearing-impaired speakers. Further, the male and female semi-intelligible hearing-impaired speakers failed to demonstrate the trend, as exhibited by the other speakers, for lingua-alveolar fricatives to be produced with greater air flow than the labiodental fricatives. The data from this investigation provide additional evidence to support the assumption that some hearing-impaired speakers fail to control and coordinate the biomechanical aspects of speech properly.

Adult↗
PubMed1993

Prevalence of hearing impairment and hearing complaints in older adults: a study in general practice.

In one general practice, 660 people aged 60 years or over were screened by means of pure tone audiometry and a specific questionnaire to assess the prevalence of hearing impairment and hearing complaints. Hearing impairment was defined as an average loss of 35 dB or more in the 1, 2 and 4 kHz frequencies in one or both ears. In total, 37.4% (95% CI, 33.3-41.1%) of the participants was hearing impaired. The prevalence was higher in men (55.1%) than in women (44.9%) and clearly increased with age in both sexes. The prevalence of hearing complaints in terms of hearing difficulties and/or tinnitus, was 37.3% (95% CI, 33.6-41.0%), and increased with age, especially in women. Of the subjects with hearing impairment, 64.4% reported hearing complaints. Of the subjects without hearing impairment, 21.1% experienced hearing complaints. This study suggests that screening older adults with relatively simple methods, may identify a large proportion of men and women in general practice with hearing problems. Providing information to both patients and general practitioners about the possibilities of hearing improvement is a crucial step in making people become more aware of hearing problems. This could ultimately lead to improvement of the quality of life of older men and women with hearing problems.

Age Factors↗
PubMed1993

Epidemiology of hearing disorders. Some factors affecting hearing. The Copenhagen Male Study.

This epidemiological investigation reports on the results from a 10-year follow-up examination concerning hearing and factors known to cause hearing problems. In addition, an evaluation concerning the possible association between hearing impairment and factors affecting the state of health is reported. The original sample comprised 5,050 subjects, and at the present examination 3,387 (67%) males at a median age of 63 years (range 53-75) participated. An increasing prevalence of 30-40% of hearing problems was demonstrated with increasing age. A prevalence of 17% of tinnitus of more than 5 min duration was found; 3% indicated that their tinnitus was so annoying that it interfered with sleep, reading and/or concentration. The prevalence of tinnitus increased up to the age of 70, and seemed to remain constant thereafter. A significant correlation between experienced hearing problems and environmental factors causing damage to the hearing organ was found. Furthermore, a correlation between hearing problems and C3-S complement was found, but no correlations could be established between hearing problems and other blood groups. No correlation was found between cardiovascular disease and hearing problems except for minor circulatory problems, nor between hearing problems and hormonal diseases. It is concluded that the present study supports previous epidemiological investigations concerning the prevalence of hearing problems and factors affecting hearing. The association between hearing problems and C3-S complement, which to the authors' knowledge has not previously been reported, should be further evaluated. No association was found between hearing problems and other blood groups.

Age Factors↗
PubMed2002

Reduced hearing, ownership, and use of hearing aids in elderly people in the UK--the MRC Trial of the Assessment and Management of Older People in the Community: a cross-sectional survey.

BACKGROUND: Reduced hearing in elderly people is important because it is disabling and potentially treatable. We aimed to assess the prevalence of reduced hearing in elderly people and levels of ownership of hearing aids and use. METHODS: We have done a cross-sectional survey of people aged at least 75 years in 106 family practices in the UK. We obtained self-reported data on hearing difficulties for 32,656 people and gave 14,877 a whispered voice test (response rate 78%). FINDINGS: 2537 (8%) of 32,656 participants reported a lot of difficulty hearing and 13,630 (42%) a little or a lot of difficulty. 3795 (26%) of 14877 participants who completed the whispered voice test (95% CI 23-29) failed the test, the proportion rising sharply with age. Following wax removal, 343 passed a retest, leaving 3452 (23%, 20-26) who failed the test, even after wax removal if present. 998 (46%) of 2180 people wearing a hearing aid at the time of testing failed the whispered voice test. More than half the people who failed the test did not own a hearing aid. 2200 (60%) of 3846 people who owned a hearing aid said they used it regularly. Level of use was strongly related to perceived benefit. INTERPRETATION: Reduced hearing is common and provision of hearing aids inadequate in elderly people. Many people who own a hearing aid do not use it regularly, and even when wearing their aid many still have socially disabling levels of hearing loss. A major source of morbidity in elderly people could be alleviated by improvements in detection and management of reduced hearing.

Aged↗
PubMed2003

Assessment of hearing and hearing disorders in rock/jazz musicians.

The aim of this study was to assess hearing and hearing disorders among rock/jazz musicians. One hundred and thirty-nine (43 women and 96 men) musicians participated. The results are based on pure-tone audiometry and questionnaire responses. According to our definition of hearing loss, tinnitus, hyperacusis, distortion and/or diplacusis as hearing disorders, we found disorders in 74%, of the rock/jazz musicians studied. Hearing loss, tinnitus and hyperacusis were most common, and the latter two were found significantly more frequently than in different reference populations. The women showed bilateral, significantly better hearing thresholds at 3-6 kHz than the men. Hyperacusis, and the combination of both hyperacusis and tinnitus, were found to be significantly more frequent among women than among men. Hearing loss and tinnitus were significantly more common among men than among women. It is important to evaluate all kinds of hearing problems (other than hearing loss) in musicians, since they represent an occupational group especially dependent on optimal, functional hearing. On the basis of our results, we suggest that hearing problems such as tinnitus, hyperacusis, distortion and/or diplacusis should, in addition to hearing loss, be defined as hearing disorders.

Acoustic Stimulation↗