Search Results (159)

This study examined the auditory and cognitive effects of occupational ultrasonic noise exposure through controlled laboratory experiments simulating workplace conditions. A group of 20 participants aged 18–35 underwent pure-tone audiometry (PTA) in both standard (1–8 kHz) and extended high-frequency (9–16 kHz) ranges before and after exposure to airborne ultrasound emitted by an ultrasonic cleaner. The exposure was conducted at two sound pressure levels: at the current permissible occupational limit and at a level 5 dB below it. The results demonstrated statistically significant temporary threshold shifts (TTS) in hearing sensitivity (bilaterally) at 8 kHz and 16 kHz only at the higher exposure level, with mean shifts reaching 3.8 dB and 5.8 dB, respectively. No significant hearing threshold changes were observed at the reduced exposure level. Additionally, participants completed a battery of Abilitest cognitive tests during exposure. Comparisons with standardized normative data showed that reaction times were approximately 20% longer in simple response tasks and 13% longer in selective attention tasks, suggesting a potential deviation in cognitive performance associated with ultrasonic noise. These findings support the need to reevaluate current occupational exposure limits and highlight the potential health and performance risks associated with airborne ultrasound. Full article

Background/Objectives: This study aims to explore both the psychosocial outcomes of hearing aid use and the factors that differentiate users from non-users among older adults with sensorineural hearing loss (SNHL) in Romania. Methods: We conducted a cross-sectional, comparative study with follow-up, including 201 patients aged between 49 and 92 years (mean age 70.76 ± 11.86 years), diagnosed with moderate to severe SNHL, evaluated between 1 November 2023, and 30 November 2024, at the Municipal Clinical Hospital Orăștie, Romania. Audiological assessment involved pure-tone audiometry and speech testing. Outcome measures included the Word Recognition Score (WRS), International Outcome Inventory for Hearing Aids (IOI-HA), Hearing Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and the Self-Esteem Scale (SES). Results: Of the 201 patients, 105 (52.2%) accepted hearing aid (HA) fitting and 96 (47.8%) declined. No significant differences were found in age (p = 0.565) or sex (p = 0.476) between groups. HA users reported significantly lower perceived handicap (HHIA: 46.48 ± 24.83 vs. 77.74 ± 28.02, p = 0.015) and higher self-esteem scores (SES: 35.68 ± 4.88 vs. 23.03 ± 4.90, p < 0.001), while tinnitus-related distress (THI) did not differ significantly (p = 0.785). Word recognition scores improved significantly post-fitting across all degrees of hearing loss: moderate (48.52% → 86.13%), moderately severe (47.47% → 85.31%), and severe (47.55% → 85.46%), all p < 0.001. Conclusions: Hearing aid use in older adults with SNHL was associated with significant improvements in speech perception and reduced perceived hearing handicap. These benefits were consistent across all severity levels and were independent of unilateral or bilateral device use. The difference in self-esteem observed between users and non-users may reflect pre-existing psychological factors influencing HA adoption, underlining the importance of personalized counseling in hearing rehabilitation. Full article

Background: Hearing loss (HL) affects more than 1.5 billion people worldwide and represents a major global health concern. Recent evidence suggests that alterations in gut microbial composition and antimicrobial resistance (AMR) may be linked to inflammatory and metabolic pathways that could influence auditory physiology. Objectives: This study aimed to explore the relationship between auditory function and the antimicrobial resistance in the gut microbiome of young adults. Methods: Fecal and auditory data were collected from young adults. Auditory function was assessed through pure-tone audiometry, and participants were classified according to the presence or absence of HL based on the American Speech-Language-Hearing Association (ASHA) criteria. Bacterial resistance was analyzed under aerobic and anaerobic conditions using disk diffusion and E-test methods to determine minimum inhibitory concentrations (MICs) for a panel of antibiotics. Gut microbiota composition was further characterized using quantitative polymerase chain reaction (qPCR) to quantify 15 key microbial taxa. Results: Overall, 40.9% of participants presented some degree of HL, with mild or slight HL being more frequent in women (53.3%) than in men (14.3%). Participants with HL exhibited significantly higher MICs for nalidixic acid, amoxicillin, and ciprofloxacin, as well as trends toward increased MIC variability for several other agents. Principal component analysis demonstrated distinct clustering of individuals without HL and greater dispersion among those with HL, suggesting higher interindividual variability in resistance profiles. These findings suggest potential associations between antimicrobial resistance and auditory function, possibly mediated through gut microbiome alterations. qPCR analyses demonstrated that Faecalibacterium prausnitzii abundance was significantly higher in individuals with HL and in those exhibiting greater resistance to amoxicillin. Conclusions: These findings provide preliminary evidence connecting the gut resistome with auditory function, supporting the emerging concept of a gut–ear–brain axis and underscoring the need for further research into microbiome-related mechanisms underlying HL. Full article

Background/Objectives: Children with perinatal HIV (PHIV) are more at risk for hearing loss than HIV-unexposed (HU) children. Due to medical advances maternal HIV transmission to newborns is decreasing, but in children with perinatal HIV exposure, uninfected (PHEU) is increasing. The objectives were to evaluate (1) pure-tone audiometry and cochlear and auditory neural function in children with perinatally acquired HIV (PHIV), children with perinatal HIV exposure but uninfected (PHEU), and HIV-unexposed (HU) children and (2) differences in hearing measures for children with PHIV according to HIV disease severity. Methods: Three hundred and thirty-three children (105 PHIV [58 girls, 47 boys], 101 PHEU [51 girls, 50 boys], and 127 HU [65 girls, 62 boys]), aged 11–14 years, completed a hearing assessment that included a hearing-related questionnaire, otoscopy, tympanometry, pure-tone thresholds, distortion product otoacoustic emissions (DPOAEs) for cochlear function, and auditory brainstem responses (ABRs) for neural function. Results: Pure-tone thresholds, DPOAE, and ABR measures were similar in the three groups. Children with PHIV had a higher prevalence of hearing loss compared to children with PHEU and HU children. Children with PHIV and greater historical HIV disease severity had similar hearing, DPOAEs, and ABRs to those with lesser HIV disease severity. Conclusions: In utero HIV acquisition or HIV exposure might not affect the cochlear and neural function up to the level of the brainstem. Children with PHIV had a higher prevalence of hearing loss; it is possible there is a difference in central auditory processing across the three groups of children. Hearing loss identification is important since it may impact social and educational development. Full article

Background: Traditional audiological assessment often does not properly reflect the challenges experienced by cochlear implant (CI) users in complex listening environments. Deficits in speech recognition and sound localization ability persist despite clinically satisfactory audiometric thresholds. Objective: The objective of this study is to evaluate the impact of acoustic environment complexity on speech recognition and sound localization ability in CI users compared to normal-hearing (NH) individuals and to assess subjective auditory performance using validated questionnaires. Methods: Thirty-four unilateral CI users and fifty NH participants were evaluated in a sound environment audiometric room equipped with an eight-speaker 360° array. The variables examined were pure-tone average (PTA), word recognition score (WRS) in quiet and noise (sea, traffic, cafeteria), sound localization ability, and the SSQ-12 auditory quality questionnaire. Correlation, regression, and MANOVA analyses examined associations among objective and subjective outcomes. Results: CI users exhibited significantly lower WRS in quiet and noise conditions, reduced sound localization, and decreased SSQ-12 scores compared to NH participants, with performance declining as noise complexity increased. Pre-implant PTA was the strongest predictor of post-implant speech recognition. No significant differences were observed between unilateral CI users and those with bimodal fittings. The SSQ-12 questionnaire correlated with objective measures, supporting its clinical relevance. Conclusions: CI users exhibit persistent deficits in ecologically valid listening conditions not demonstrated by standard audiometry. Integrating sound field testing and validated hearing quality questionnaires may provide a more comprehensive assessment to guide personalized rehabilitation and device programming. Full article

Background and Clinical Significance: Vestibular disorders include a wide range of conditions with overlapping symptoms such as dizziness, vertigo and imbalance, often offering diagnostic challenges when distinguishing between peripheral and central etiology. Accurate differentiation is essential for establishing effective treatment plans. In rare or atypical cases with subtle findings, comprehensive diagnostic tools—such as extended vestibular tests and structured questionnaires like the Dizziness Handicap Inventory (DHI)—are critical for diagnosis and monitoring patient recovery. Case Presentation: A 35-year-old female presented with chronic imbalance and motion-induced dizziness persisting for four years. The patient had a surgical history of right-sided functional neck dissection for a parotid tumor. A comprehensive audiovestibular evaluation was performed, including pure tone audiometry (PTA), tympanometry, videonystagmography (VNG), cervical vestibular evoked myogenic potentials (cVEMP), ocular vestibular evoked myogenic potentials (oVEMP), video head impulse testing (vHIT), computerized dynamic posturography (CDP), and magnetic resonance imaging (MRI). The Dizziness Handicap Index (DHI) was administered at baseline and post-treatment to monitor subjective symptom changes. Objective testing revealed marked right–left amplitude asymmetry on cVEMP, which were recorded from the trapezius muscle due to prior neck dissection surgery, indicating isolated right-sided saccular hypofunction. Following targeted vestibular rehabilitation and pharmacologic treatment, the 3-month reassessment demonstrated resolution of symptoms and a reduction in DHI scores from 24 to 6. Conclusions: Comprehensive vestibular testing, performed in a single diagnostic session, enabled the accurate identification of isolated right-sided saccular hypofunction in this complex post-surgical case. Combining cVEMP, CDP, and DHI assessment provided a complete functional profile, guided targeted rehabilitation, and allowed objective monitoring of recovery. Full article

Background: Superior semicircular canal dehiscence (SSCD) is characterized by a bony defect of the superior semicircular canal (SSC), leading to vestibular and auditory symptoms. A process of spontaneous “auto-plugging,” in which the overlying dura mater progressively occludes the SSC, may replicate the effects of surgical canal plugging but remains under-recognized. The present study reports diverse clinical, instrumental, and 3d High Resolution MRI findings in patients with SSCD and subsequently confirmed to present with spontaneous complete or partial auto-plugging. Methods: We retrospectively reviewed 11 patients with SSCD diagnosed on high-resolution CT and suspected auto-plugging based on clinical atypia and large dehiscence (>4 mm). Patients underwent comprehensive neurotological assessment, including pure-tone audiometry, vestibular testing, and HR MRI with 3D labyrinthine reconstructions to identify partial or complete auto-plugging. Auto-plugging was classified as partial (Canalis semicircularis superior depressus) or complete (absence of endolymph fluid signal; Canalis semicircularis superior obturatus). Results: Among 13 ears with auto-plugging, 6 were partial and 7 complete. The mean SSCD size in auto-plugged ears was 5.5 mm. Most ears had normal or near-normal vestibular function on VHIT, with minimal air-bone gaps and preserved VEMP responses. Imaging demonstrated varying degrees of dural contact with the SSC, confirming partial or complete canal occlusion. Conclusions: Spontaneous auto-plugging of the SSC is a plausible, under-recognized phenomenon that may reproduce functional effects of surgical plugging. Dedicated 3D labyrinthine MRI enhances detection and characterization. Prospective multimodal studies are needed to clarify the pathophysiology, progression, and clinical implications, optimizing patient selection for surgical versus conservative management. Full article

Background/Objectives: Shift work in healthcare professionals affects performance in high cognitive processing, especially in complex environments. However, the beneficial effects that working in complex environments may have on auditory–cognitive processing remain unknown. These professionals face increased challenges in decision-making due to factors such as noise exposure and sleep disturbances, which may lead to the development of enhanced auditory–cognitive resources. This study aims to investigate the associations between shift work and auditory–cognitive processing in middle-aged healthcare workers. Methods: Thirty middle-aged healthcare workers were equally allocated to a shift worker (SW) or a fixed-schedule worker (FSW) group. Performance on a cognitive test, and in pure-tone audiometry, speech in quiet and noise, and listening effort were used to explore whether correlations were specific to shift work. Results: Exploratory analyses indicated that shift workers tended to perform better in visuospatial/executive function, memory recall, memory index, orientation, and total MoCA score domains compared to fixed-schedule workers. In the SW group, hearing thresholds correlated with memory recall and memory index. In the FSW group, hearing thresholds correlated with orientation, memory index, and total MoCA score, while listening effort correlated with naming, and speech intelligibility in quiet correlated with total MoCA scores. Conclusions: These exploratory findings suggest that shift work may be linked to distinct auditory–cognitive patterns, with potential compensatory mechanisms in visuospatial/executive functions and memory among middle-aged healthcare workers. Larger, longitudinal studies are warranted to confirm whether these patterns reflect true adaptive mechanisms. Full article

Background: Recreational noise exposure from personal listening devices (PLDs) may lead to hidden hearing loss (HHL), affecting auditory nerve function despite normal pure-tone audiometry (PTA) and otoacoustic emissions (OAE). Subclinical auditory damage at the synaptic level often goes undetected by conventional assessments, emphasizing the need for more sensitive measures. Recorded click ABR in the presence of various levels of ipsilateral maskers for the better identification of auditory damage at the synaptic level. These results could help to develop a better objective diagnostic tool that can detect hidden hearing loss. Objective: To examine the effects of PLD usage on extended high-frequency audiometric thresholds and on click-evoked auditory brainstem responses (ABR) with and without ipsilateral masking in individuals with normal hearing. Materials and Methods: Thirty-five young adults aged 18–35 years (18 PLD users, 17 controls) with clinically normal hearing were recruited. Extended high-frequency audiometry (EHFA) was conducted from 9 to 16 kHz. Click-evoked ABRs were recorded at 80 dB nHL under unmasked and ipsilateral broadband noise-masked conditions at 50, 60, and 70 dB SPL. ABR analyses included absolute and relative amplitude (V/I) and latencies of waves I, III, and V. Results: PLD users demonstrated significantly elevated extended high-frequency thresholds compared to controls. ABR analyses revealed reduced Wave I amplitudes across stimulus conditions in PLD users, while Wave V amplitudes were largely preserved, resulting in consistently higher V/I amplitude ratios under masked conditions. No group differences were observed for Wave III amplitudes or absolute/interpeak latencies, except for a modest prolongation of I–III latency at one masker level in PLD users. Conclusions: Conventional audiological tests may not detect early auditory damage; however, extended high-frequency audiometry and ABR with ipsilateral masking demonstrate greater sensitivity in identifying noise-induced functional changes within the auditory brainstem pathways. Full article

Background and Objectives: This study aimed to investigate the influence of continuous positive airway pressure in patients with obstructive sleep apnoea on hearing and the possibility of recovering cochlear receptor cells. Materials and Methods: Forty-two patients with obstructive sleep apnoea (OSA) were assigned to the study group. Patients underwent pure-tone audiometry and transient-evoked (TEOAE) and distortion-product (DPOAE) otoacoustic emissions before starting continuous positive airway pressure (CPAP) therapy and six months after CPAP therapy. Subjects were further divided into the following two groups: those who adequately used the therapy and those who did not adhere to treatment recommendations. Results: There is no significant difference in hearing thresholds for specific frequencies after six months of CPAP therapy. There is no significant difference in TEOAE and DPOAE SNR values at any frequency after 6 months of CPAP therapy. There is no significant difference in hearing threshold results for specific frequencies as a function of subject co-operation with treatment. After therapy, there is a significant difference in the SNR values in TEOAEs at 2 kHz and 4 kHz in subjects of the OSA target group, depending on co-operation, being higher in co-operative subjects, while there are no significant differences at other frequencies. There is a significant difference in the SNR results in DPOAEs, where they are higher in co-operative subjects at 1000, 6000, 7000 and 8000 Hz. Conclusions: The use of continuous positive airway pressure as a therapy for OSA has no effect on hearing and cochlear receptor cell recovery. Co-operation with CPAP treatment does not affect hearing threshold, but does affect cochlear receptor cell function, which is better at mid and higher frequencies in those who co-operate. These findings underscore the clinical significance of treatment adherence. Consistent adherence is associated with measurable improvements in hearing, particularly at higher frequencies, which cannot typically be evaluated in routine clinical practice using standard pure-tone audiometry. Our results emphasise the importance of promoting compliance with CPAP therapy not only for cardiovascular and neurological protection, but also for maintaining hearing health. Full article

Background/Objectives: Hearing loss is a prevalent sensory impairment in older adults, linked to reduced quality of life, cognitive decline, and social isolation. While it usually begins in the high-frequency range, some individuals present with isolated low-frequency hearing loss (LFHL). The long-term prognostic implications of such frequency-specific patterns remain unclear. This study aimed to evaluate the risk of long-term hearing deterioration by initial hearing loss type: LFHL, high-frequency hearing loss (HFHL), and combined-frequency hearing loss (CFHL). Methods: We retrospectively analyzed pure-tone audiometry (PTA) data from 10,261 patients who underwent at least two pure-tone audiometry assessments between 2011 and 2022 at a tertiary hospital. Each ear was treated as an independent observation. Hearing loss was defined as a threshold > 20 dB HL at 250, 500, 4000, or 8000 Hz. Participants were classified into normal hearing (NH), LFHL, HFHL, and CFHL groups. The outcome was a final four-frequency pure-tone average (4PTA) ≥ 40 dB HL. Logistic regression adjusted for age and sex was used, with subgroup analyses by follow-up duration. Results: HFHL (OR = 1.66, 95% CI: 1.47–1.89) and CFHL (OR = 2.23, 95% CI: 1.97–2.53) showed significantly higher risks of hearing loss compared with NH. LFHL did not show a significant increase (OR = 0.94, 95% CI: 0.76–1.16). These results were consistent across follow-up durations, with CFHL showing the most extensive deterioration. Conclusion: HFHL is a strong predictor of long-term auditory decline, and risk is further elevated with CFHL. In contrast, isolated LFHL was not associated with increased risk, suggesting relatively favorable outcomes. Frequency-specific classification may aid risk stratification and long-term monitoring strategies. Full article

Background: Despite the widespread use of antibiotics, acute mastoiditis (AM) and related complications resulting from acute purulent otitis media continue to occur, predominantly in children. Although numerous studies have focused on the pathogenesis, aetiological agents, and treatment of AM, comprehensive investigations of the long-term outcomes of AM and the physiological consequences of surgical intervention in the temporal bone are lacking. Methods: Thirty patients who had undergone mastoidectomy for acute mastoiditis at a median age of 2.12 years were invited for evaluation at least five years postoperatively. The assessment included the Chronic Otitis Media Questionnaire 12, clinical examination with otomicroscopy, extended high-frequency pure-tone audiometry, distortion product otoacoustic emissions, middle ear impedance testing, and a newly developed protocol for noninvasive mastoid function measurement. Results were compared with a control group of 30 ears and with a group of 30 ears treated solely with tympanostomy for acute otitis media at risk of mastoiditis. Results: Although mean Chronic Otitis Media Questionnaire 12 scores were below 1 point, patients who had undergone mastoidectomy reported slightly greater difficulties with hearing in both quiet and noisy environments, along with an increased perception of tinnitus and unpleasant sensations around the ear. Otomicroscopy revealed minor structural changes in the test groups, which were absent from the control group. Pure-tone audiometry demonstrated approximately 10 dB higher thresholds at high and extended high frequencies, with similar findings observed in the distortion product otoacoustic emissions. Middle ear impedance testing indicated elevated stapedius reflex thresholds in the mastoidectomy group, while other parameters showed no statistically significant differences. Mastoid function testing demonstrated preserved pressure-buffering capacity but reduced thermal insulation of the vestibular organ under extreme thermal stimulation—an occurrence rarely encountered in daily life. Conclusions: In the long term, most patients recovering from acute mastoiditis exhibit only minor functional and structural sequelae, and the impact of mastoidectomy appears negligible compared with less invasive surgical interventions. Full article

Background/Objectives: This study evaluated the feasibility of predicting bone conduction (BC) thresholds and classifying air–bone gap (ABG) status using only air conduction (AC) data obtained from pure tone audiometry (PTA). Methods: A total of 60,718 PTA records from five tertiary hospitals in the Republic of Korea were utilized. Input features included AC thresholds (0.25–8 kHz), age, and sex, while outputs were BC thresholds (0.25–4 kHz) and ABG classification based on 10 dB and 15 dB criteria. Five machine learning models—deep neural network (DNN), long short-term memory (LSTM), bidirectional LSTM (BiLSTM), random forest (RF), and extreme gradient boosting (XGB)—were trained using 5-fold cross-validation with Synthetic Minority Over-sampling Technique (SMOTE). Model performance was evaluated based on accuracy, sensitivity, precision, and F1 score under ±5 dB and ±10 dB thresholds for BC prediction. Results: LSTM and BiLSTM outperformed DNN in predicting BC thresholds, achieving ~60% accuracy within ±5 dB and ~80% within ±10 dB. For ABG classification, all models performed better with the 10 dB criterion than the 15 dB. Tree-based models (RF, XGB) achieved the highest classification accuracy (up to 0.512) and precision (up to 0.827). Confidence intervals for all metrics were within ±0.01, indicating stable results. Conclusions: AI models can accurately predict BC thresholds and ABG status using AC data alone. These findings support the integration of AI-driven tools into clinical audiology and telemedicine, particularly for remote screening and diagnosis. Future work should focus on clinical validation and implementation to expand accessibility in hearing care. Full article

Background/Objectives: Obstructive Eustachian tube dysfunction (OETD) is common in adults and may lead to middle-ear conditions such as atelectasis and cholesteatoma. The ETDQ-7 questionnaire is used to assess symptom severity. Balloon dilation of the Eustachian tube (BDET) is a minimally invasive treatment with variable outcomes. This review evaluates the safety and effectiveness of BDET. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Four databases (PubMed, Scopus, Cochrane, Web of Science) were searched using ETD- and BDET-related terms, with the last search on 11 April 2025. Randomized trials were selected based on predefined criteria, and data were extracted by two independent reviewers. Discrepancies were resolved by consensus. Results: This systematic review included 14 studies on BDET published between 2013 and 2025. BDET improved otoscopic findings, Valsalva maneuver (VM) performance, and tympanometry (TMM), particularly within the first 6 weeks. ETDQ-7 scores generally indicated symptom improvement, though pure tone audiometry (PTA) showed no significant changes. Most procedures were performed under general anesthesia, with some studies showing similar outcomes under local anesthesia. Combining BDET with other interventions produced mixed results. Reported complications were rare. Conclusions: BDET is a safe, low-risk procedure that effectively reduces tympanic membrane retraction and improves VM and TMM results. While it relieves ETD symptoms in many patients, evidence for long-term efficacy and impact on PTA is limited. Full article

Objective: To evaluate the outcomes of a modified infratemporal fossa approach (ITFA) that preserves the posterior external auditory canal (EAC) in patients with tumors in the infratemporal fossa and skull base, focusing on postoperative hearing and facial nerve function. Methods: This retrospective study included nine patients who underwent ITFA with posterior EAC preservation for tumor removal while minimizing facial nerve rerouting. All surgeries were performed by a single surgeon. Preoperative and postoperative hearing levels, facial nerve function, tumor characteristics, and surgical outcomes were analyzed. Air-bone gaps (ABG) were assessed using pure tone audiometry, and facial nerve function was assessed using the House–Brackmann grading system. Results: The cohort consisted of eight female patients and one male patient, with a mean tumor size of 3.0 cm. Surgical outcomes were promising, with no statistically significant increase in postoperative ABG and well-preserved facial nerve function. Only one patient developed postoperative grade II facial palsy. A residual tumor was identified in one case with extensive meningioma, which has remained stable, and no recurrence or regrowth was noted during the follow-up period (mean: 3.7 years). The modified approach minimized complications related to conductive hearing loss and facial nerve dysfunction. Conclusions: The modified ITFA with posterior EAC preservation provides a promising alternative to conventional ITFA for managing deep-seated tumors. It preserves both hearing and facial nerve function while ensuring adequate tumor resection. Full article