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At least 1,207 records · Page 67Linked to original sources
PubMed2003

Risk factors for tinnitus in a population of older adults: the blue mountains hearing study.

OBJECTIVE: To identify potential and modifiable risk factors for tinnitus in a population of older adults. STUDY DESIGN: Cross-sectional study. Detailed questionnaires were interviewer-administered in a representative sample of 2015 persons aged 55+ yr, living in an area west of Sydney, Australia. Air- and bone-conduction audiometric thresholds were measured from 250 to 8000 Hz and from 500 to 4000 Hz, respectively. TEOAE and SOAE were measured for both ears. RESULTS: After adjusting for multiple variables in a Cox proportional hazards model, factors that significantly increased the risk of tinnitus were poorer hearing and cochlear function, self-reported work-related noise exposure, and history of middle ear or sinus infections, severe neck injury or migraine. CONCLUSION: Interventions aimed at reducing age-related hearing loss, particularly by reducing excessive work-related noise exposure, and the effective, timely treatment of ear-related infections, may all decrease the risk of tinnitus.

Aged↗
PubMed2006

Using a combination of click- and tone burst-evoked auditory brain stem response measurements to estimate pure-tone thresholds.

DESIGN: A retrospective medical record review of evoked potential and audiometric data were used to determine the accuracy with which click-evoked and tone burst-evoked auditory brain stem response (ABR) thresholds predict pure-tone audiometric thresholds. METHODS: The medical records were reviewed of a consecutive group of patients who were referred for ABR testing for audiometric purposes over the past 4 yrs. ABR thresholds were measured for clicks and for several tone bursts, including a single-cycle, Blackman-windowed, 250-Hz tone burst, which has a broad spectrum with little energy above 600 Hz. Typically, the ABR data were collected because the patients were unable to provide reliable estimates of hearing sensitivity, based on behavioral test techniques, due to developmental level. Data were included only if subsequently obtained behavioral audiometric data were available to which the ABR data could be compared. Almost invariably, the behavioral data were collected after the ABR results were obtained. Because of this, data were included on only those ears for which middle ear tests (tympanometry, otoscopic examination, pure-tone air- and bone-conduction thresholds) indicated that middle ear status was similar at the times of both tests. With these inclusion criteria, data were available on 140 ears of 77 subjects. RESULTS: Correlation was 0.94 between click-evoked ABR thresholds and the average pure-tone threshold at 2 and 4 kHz. Correlations exceeded 0.92 between ABR thresholds for the 250-Hz tone burst and low-frequency behavioral thresholds (250 Hz, 500 Hz, and the average pure-tone thresholds at 250 and 500 Hz). Similar or higher correlations were observed when ABR thresholds at other frequencies were compared with the pure-tone thresholds at corresponding frequencies. Differences between ABR and behavioral threshold depended on behavioral threshold, with ABR thresholds overestimating behavioral threshold in cases of normal hearing and underestimating behavioral threshold in cases of hearing loss. CONCLUSIONS: These results suggest that ABR thresholds can be used to predict pure-tone behavioral thresholds for a wide range of frequencies. Although controversial, the data reviewed in this paper suggest that click-evoked ABR thresholds result in reasonable predictions of the average behavioral thresholds at 2 and 4 kHz. However, there were cases for which click-evoked ABR thresholds underestimated hearing loss at these frequencies. There are several other reasons why click-evoked ABR measurements were made, including that they (1) generally result in well-formed responses, (2) assist in determining whether auditory neuropathy exists, and (3) can be obtained in a relatively brief amount of time. Low-frequency thresholds were predicted well by ABR thresholds to a single-cycle, 250-Hz tone burst. In combination, click-evoked and low-frequency tone burst-evoked ABR threshold measurements might be used to quickly provide important clinical information for both ends of the audiogram. These measurements could be supplemented by ABR threshold measurements at other frequencies, if time permits. However, it may be possible to plan initial intervention strategies based on data for these two stimuli.

Acoustic Stimulation↗
PubMed2006

Alternobaric vertigo--really a hazard?

OBJECTIVE: To determine the prevalence of alternobaric vertigo (AV) in sport divers and to find out whether AV led to dangerous situations underwater. Furthermore, to examine whether objective neurootologic tests are associated with the manifestation of AV. DESIGN: Retrospective cohort study. PARTICIPANTS: Sixty-three sport divers with an average diving experience of 10 years and 650 dives were questioned regarding their medical and diving history and the manifestation of vertigo during diving. METHODS: Microscopic otoscopy, tympanometry, stapedius reflexes, hearing threshold for air and bone conduction, caloric video-oculography including analysis of the slow-phase velocity of the nystagmus, acoustic brain stem responses, and magnetic resonance imaging were performed to find possible differences between divers with and without AV. RESULTS: We found 17 divers with AV (27%). There was no significant difference in all measured parameters apart from sex and history of middle ear equalization difficulty in divers with AV. Ten (59%) of 17 female divers and 7 (15%) of 46 male divers experienced AV, representing a significant sex difference (p < 0.001). Correlation with our divers' outpatient clinic revealed that female divers had a significantly higher incidence of middle ear equalization disorders which could be an explanation for the predominance of female divers with symptoms of AV. None of the divers reported any dangerous or life-threatening situations following AV. Whether AV leads to dangerous situations underwater remains unclear, but this hypothesis is not supported by our data. CONCLUSION: Alternobaric vertigo is a common finding in divers. In our study group, female divers had a four-time higher risk to suffer AV. Our data do not support the thesis that AV is a life-threatening condition.

Acoustic Impedance Tests↗
PubMed2005

Vestibular-evoked myogenic potentials in infancy and early childhood.

OBJECTIVE: Hearing impairment and the often concurrent loss of vestibular function, which is rarely assessed in infants, can both impair sensory integration critical to the development of normal motor coordination. This study demonstrates, for the first time, that vestibular function in infants can be noninvasively assessed using vestibular-evoked myogenic potentials (VEMPs). Our intentions were to demonstrate that VEMPs can be reliably recorded from neonates and to compare neonatal VEMPs with those obtained from normal adults. STUDY DESIGN: Prospective cohort study. METHODS: Myogenic evoked potentials induced by air- and bone-conducted auditory stimuli were recorded from the sternocleidomastoid muscles of 12 normal neonates and 12 neonates with various clinical findings. These included infants with bilateral atresia of the external auditory canals, Treacher-Collins syndrome, and neonates who failed universal neonatal screening. RESULTS: With the exception of one patient with hearing loss, reproducible biphasic VEMPs were recorded from the sternocleidomastoid muscle of all the infants using loud, short tone-burst sounds. CONCLUSIONS: The VEMP has characteristics that differentiate it from the postauricular response and the Jaw reflex. The VEMPs were dominant on the side ipsilateral to the stimulated ear. The overall morphology of the neonatal VEMP is quite similar to that of adults. The major neonatal differences are a shorter latency of the n23 peak and higher amplitude variability. Our results suggest that recording of the VEMP in neonates with various audio-vestibular problems provides useful information about vestibular function in this population and may provide information that leads to better care and rehabilitation for neonates at risk of developmental and motor system delay.

Audiometry, Pure-Tone↗
PubMed1978

Modified technique of tympanoplasty with functional results of 494 cases after 3 years.

This paper gives the functional preliminary and final results of tympanoplasty as modified by Khan in types I--III in the form of a comparison. We examined 494 patients who were operated according to our modified technique. It is emphasized that in reconstruction of the middle ear, the use of a prepared fascial graft, homograft incus cartilage and external auditory meatal flap is sufficient. The preliminary and final results were documented with the aid of audiograms which were described and critically appraised according to two different types of evaluation. The evaluation did not only include the hearing results of tympanoplasty, but also the change in individual frequencies for all types. According to our appraisal of the operations with regard to social hearing the functional results of operations performed in our clinic may be considered above average. The hearing gain achieved from the preliminary postoperative control to the final examination is especially satisfying, since it also includes an improvement in bone conduction values.

Auditory Threshold↗
PubMed1991

Composite tragal perichondrial/cartilage autografts vs cartilage or bone paste grafts in tympanoplasty.

Extrusion of plastic or ceramic implants is a significant cause of failure in ossiculoplasty for chronic ear disease. This paper reports the use of a composite tragal cartilage and perichondrial autograft compared to cartilage or bone paste between the graft and tympanic membrane. At 2 years, there were no extrusions in the group with the composite graft (n = 18) and 5 extrusions in the cartilage/bone paste group (n = 18) (P = 0.02). The mean average air-bone gap was significantly better for the composite grafts at 2 years (15 dB vs 24 dB) (P less than 0.05). Extrusions were eliminated and hearing results better at 2 years using the composite graft.

Biocompatible Materials↗
PubMed1993

Value of computed tomography (CT) in the diagnosis of cochlear otosclerosis.

The temporal bones of 40 patients with surgically confirmed otosclerosis were studied with high-resolution CT. The hearing of these patients was re-examined 5 years later. Foci of demineralization in the cochlear capsule were detected in 36% of operated ears and in 44% of otosclerotic ears not operated on. Mean bone conduction (BC) thresholds of ears with positive radiological findings did not differ significantly from those of otosclerotic ears with normal CT, either at the time of CT examination or 5 years later. Over 5 years, elevation of BC thresholds by 10 dB or more was observed significantly more often in operated ears with abnormal CT than in operated ears with normal CT, but in otosclerotic ears not operated on the corresponding difference was non-significant. It was concluded that CT examination is of little value in predicting sensorineural hearing loss in patients with otosclerosis.

Adult↗
PubMed2005

A prospective evaluation of the Essen titanium stapes prosthesis.

OBJECTIVES: This is the first clinical trial to evaluate the suitability of a new titanium stapes prosthesis, which we developed jointly with the Kurz Company (Dusslingen). DESIGN: In a prospective clinical study, patients with otosclerosis underwent stapes surgery using our new titanium stapes prosthesis during a period of 14 months. One year after surgery pre- and postoperative audiograms were performed and all patients participated in a structured interview. SETTING: Tertiary otorhinolaryngological university department PARTICIPANTS: Of 49 patients with otosclerosis, entering the study, two patients were excluded, because they were not located any more. MAIN OUTCOME MEASURES AND RESULTS: All patients experienced a hearing improvement of 21 dB on average except one patient. Sixty percentage of patients achieved a reduction of the air-bone gap to less than 10 dB and 31% of patients having their air-bone gap closed to within 20 dB--averaged across 0.5, 1.0, 2.0 and 4 kHz. The hearing level improved significantly in the air and in the bone conduction thresholds. CONCLUSIONS: This paper presents our first '1 year postimplantation' results of our titanium stapes prosthesis. We consider the development of this implant to be beneficial. The results confirm significant improvement in hearing status and tinnitus levels.

Adult↗
PubMed2005

Superior canal dehiscence: review of a new condition.

A new cause of sound and pressure induced vertigo, superior canal dehisence, is described. Auditory manifestations include hyperacusis to bone-conducted sounds and conductive hearing loss with normal acoustic reflexes. The diagnosis is reached by a directed history, documentation of upward and torsional nystagmus evoked by sound and pressure, and radiology. Acoustic reflexes and VEMP (vestibular evoked myogenic potentials) aid in the identification of patients with an apparent conductive loss with normal acoustic reflexes or have an asymptomatic dehiscense on radiology. Treatment involves avoidance of the precipitating stimuli. Surgical treatment, by resurfacing the dehiscence, is considered in patients with more severe symptoms.

Acoustic Impedance Tests↗
PubMed1996

Hearing loss in former prisoners of war of the Japanese.

OBJECTIVE: To describe the prevalence, degree, and types of hearing loss present in a group of older American veterans who had been prisoners of war of the Japanese. DESIGN: A descriptive study. SETTING: A Veterans Affairs university hospital. PARTICIPANTS: Seventy-five male veterans, mean age 68 (+/- 3.6) years. INTERVENTIONS: Hearing aids were prescribed for eight veterans. MEASUREMENTS: Subjects were examined, and pure tone air and bone conduction, speech reception threshold, and speech discrimination were determined. Results were compared with age- and sex-matched controls from the largest recent American population study of hearing loss. RESULTS: 95% of subjects had been imprisoned longer than 33 months. Starvation conditions (100%), head trauma (85%), and trauma-related loss of consciousness (23%) were commonly reported. A total of 73% complained of hearing loss, and 29% (22/75) dated its onset to captivity. Most of those with the worst losses in hearing and speech discrimination were found in this subgroup. When the entire group was compared with published age- and sex-matched controls from the Framingham Study, no significant differences were found. CONCLUSIONS: We advocate screening examinations and long-term follow-up of populations with similar histories of starvation, head trauma, and torture.

Aged↗
PubMed1998

Low prevalence of hearing aid use among older adults with hearing loss: the Epidemiology of Hearing Loss Study.

OBJECTIVES: To measure the prevalence of hearing aid use among older adults with hearing loss and to identify factors associated with those currently using hearing aids. DESIGN: Population-based cohort study. SETTING: The south-central Wisconsin community of Beaver Dam. PARTICIPANTS: A total of 1629 adults, aged 48 to 92 years, who have hearing loss and are participating in the Epidemiology of Hearing Loss Study and the Beaver Dam Eye Study. MEASUREMENTS: A hearing-related risk factor and medical history questionnaire, the Hearing Handicap Inventory for the Elderly (screening version), screening tympanometry, pure-tone air- and bone-conduction audiometry, and word recognition tests were administered by trained examiners using standard protocols. RESULTS: The prevalence of current hearing aid use among those with a hearing loss (pure-tone average > 25 decibels hearing level over 500, 1000, 2000, and 4000 Hertz, worse ear) was 14.6%. The prevalence was 55% in a subset of the most severely affected participants. In univariate analyses, current hearing aid use was associated with age, severity of loss, word recognition scores, self-reported hearing loss, self-perceived hearing handicap, and history of noise exposure. Factors associated with current hearing aid use in multivariate logistic regression models were age, severity of loss, education, word recognition scores, Hearing Handicap Inventory for the Elderly (screening version) score, and self-report of a hearing loss. CONCLUSIONS: Few older adults with hearing loss are currently utilizing hearing aids. Improved screening and intervention programs to identify older adults who would benefit from amplification are needed to improve hearing-related quality of life for this large segment of the population.

Age Factors↗
PubMed1992

Clinical, immunological and bacteriological evaluation of adverse reactions to skin-penetrating titanium implants in the head and neck region.

Between 1977 and October 1989, 445 patients have been treated with bone-anchored skin-penetrating titanium implants for anchorage of facial prostheses or bone-conducting hearing aids, at the Ear, Nose and Throat Department at Sahlgren's Hospital in Gothenburg. The majority of patients had no adverse skin reactions, while a few patients were responsible for the majority of the adverse reactions. The aim of our study was to analyse differences between these groups. We started a clinical study on 9 patients with a clinical history of adverse skin reactions around the titanium implants and 9 patients without adverse skin reactions were used as controls. None of the patients had delayed hypersensitivity to titanium. Microbiological analyses showed that when there was clinical irritation, Staphylococcus aureus could be isolated.

Adolescent↗
PubMed1996

Infant hearing screening with an automated auditory brainstem response screener and the auditory brainstem response.

From 1653 babies hospitalized in the Veterans General Hospital-Taipei from 1993 to 1995, 260 infants at risk of hearing impairment were selected. The risk criteria of hearing impairment for neonates were based on the recommendation of the US Joint Committee on Infant Hearing, 1990 Position Statement. All these infants were screened with the Algo-1 Plus, an automated auditory brainstem response (ABR) screener at a mean postconceptional age of 40.7 +/- 4.5 weeks. Thirty-nine cases (39/260, 15%) involving 57 ears (57/520, 11%), failed the screening. Except for one infant who died, the babies had an ABR test for both air- and bone-conducted stimuli and an otological examination. The case-specific incidence of conductive hearing deficit at the initial ABR test was 5.4%. The prevalence of sensorineural hearing deficits was between 2.3% confirmed and 3.1% including infants who did not have follow-up tests. The kappa-value that indicated agreement between the Algo-1 and ABR results was 0.64, and the overall efficiency of using Algo-1 to correctly identify pass or failure of the ABR was 83%.

Audiometry, Evoked Response↗
PubMed2003

Inner ear function in children with Fabry disease.

AIM: The prevalence of hearing loss in patients with Fabry disease is still uncertain. This paper examines hearing loss in a group of young patients with Fabry disease. METHODS: A clinical ear nose and throat examination, pure-tone air and bone conduction audiometry, speech audiometry and middle ear testing (tympanometry and acoustic reflex testing) were carried out in four girls and two boys with Fabry disease (age, 7-17 years), receiving enzyme replacement therapy (ERT). RESULTS: None of the patients complained of a hearing disorder or suffered from hearing loss. Three female patients reported tinnitus; however, this was not reported as being a problem. One boy reported tinnitus for the first time during 6 months of ERT. CONCLUSION: Based on this small sample of patients, it appears that the hearing disorders associated with Fabry disease develop mainly in adulthood. Tinnitus may be an earlier symptom than previously thought in Fabry disease.

Adolescent↗
PubMed2003

Acoustic wave propagation in bovine cancellous bone: application of the Modified Biot-Attenborough model.

Acoustic wave propagation in bovine cancellous bone is experimentally and theoretically investigated in the frequency range of 0.5-1 MHz. The phase velocity, attenuation coefficient, and broadband ultrasonic attenuation (BUA) of bovine cancellous bone are measured as functions of frequency and porosity. For theoretical estimation, the Modified Biot-Attenborough (MBA) model is employed with three new phenomenological parameters: the boundary condition, phase velocity, and impedance parameters. The MBA model is based on the idealization of cancellous bone as a nonrigid porous medium with circular cylindrical pores oriented normal to the surface. It is experimentally observed that the phase velocity is approximately nondispersive and the attenuation coefficient linearly increases with frequency. The MBA model predicts a slightly negative dispersion of phase velocity linearly with frequency and the nonlinear relationships of attenuation and BUA with porosity. The experimental results are in good agreement with the theoretical results estimated with the MBA model. It is expected that the MBA model can be usefully employed in the field of clinical bone assessment for the diagnosis of osteoporosis.

Animals↗
PubMed2005

Measurements of tortuosity in stereolithographical bone replicas using audiofrequency pulses.

The tortuosity of five air-filled stereolithographical cancellous bone replicas has been obtained from measurements using audiofrequency pulses in a rectangular waveguide. The data obtained from the replicas yields information about anisotropy with respect to orthogonal axes of the passages that would be marrow filled in vivo. A strong relationship has been found between the acoustically measured tortuosity and the independently measured porosity. Use of stereolithographical bone replicas has the potential to simulate perforation and thinning of cancellous bone and hence evaluate the dependence of acoustic properties on cancellous bone microstructure. As an "extreme" illustration of such use, "inverses" of the original replicas have been manufactured and acoustic measurements have been made on them. The data reveal significantly greater tortuosity of the passages that are geometrically equivalent to the original solid bone structures.

Acoustic Stimulation↗
PubMed1978

Intensity of guitar playing as a function of auditory feedback.

Subjects played an electric guitar while auditory feedback was attenuated or amplified at seven sidetone levels varying 10-dB steps around a comfortable listening level. The sidetone signal was presented in quiet (experiment I) and several levels of white noise (experiment II). Subjects compensated for feedback changes, demonstrating a sidetone amplification as well as a Lombard effect. The similarity of these results to those found previously for speech suggests that guitar playing can be a useful analog for the function of auditory feedback in speech production. Unlike previous findings for speech, the sidetone-amplification effect was not potentiated by masking, consistent with a hypothesis that potentiation in speech is attributable to interference with bone conduction caused by the masking noise.

Adult↗
PubMed1985

Is real-ear attenuation at threshold a function of hearing level?

In the course of measuring the real-ear attenuation at threshold (REAT) of experimenter-inserted E-A-R foam earplugs on 100 subjects, a statistically significant correlation was observed between attenuation and hearing level (for normal listeners, HTL less than or equal to 20 dB) at test frequencies from 2-8 kHz. Listeners with more sensitive hearing obtained better protection. The relationship was most robust at 6 and 8 kHz. For hearing levels greater than 20 dB, attenuation appeared independent of hearing level. A hypothesis was developed to explain the relationship for the normal listeners, based upon the fact that the high-frequency attenuation of the earplug was nearly bone-conduction limited. The hypothesis suggested that the attenuation of a hearing protector that provided substantially lower protection would not exhibit the same relationship. Data for such a device were collected for 70 subjects, and indeed demonstrated reduced correlation between attenuation and hearing level. Implications of the results of the experiments are discussed with regard to hearing level requirements for hearing protector attenuation test subjects, utilization of hearing-impaired listeners to measure REAT at suprathreshold (with respect to normal listeners) sound pressure levels, and linearity of hearing protector attenuation as a function of sound level.

Acoustics↗