Hearing Status in Young People Using Portable Audio Players
Małgorzata Pawlaczyk-ŁuszczyńskaKamil ZaborowskiMałgorzata Zamojska-DaniszewskaPaulina Rutkowska-KaczmarekAdam DudarewiczMariola Śliwińska‐Kowalska
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Abstract The aim of this study was to evaluate the hearing status in young adults using portable audio players (PAPs) in relation to their listening habits. The study included 58 subjects, aged 22.8±2.8 years, non-occupationally exposed to noise. Questionnaire inquiry aimed at collecting personal data, the information on PAPs usage habits, self-assessment of hearing status and identification of risk factors for noise-induced hearing loss (NIHL) were performed in study subjects. Hearing tests included pure-tone audiometry (PTA) and transient-evoked otoacoustic emission (TEOAE). All subjects were PAPs users. Depending on listening habits they were divided into the subgroups of “frequent” users (>1 h/day) and “non-frequent” users (≤1 h/day). There were no significant differences between subgroups in prevalence of NIHL risk factors and self-assessment of hearing status. However, frequent users more often complained of tinnitus and hyperacusis. Majority (81.9%) of participants had normal hearing. Nevertheless, 6.9% of audiograms showed high- frequency notches typical for NIHL. Both, the PTA and TEOAE indicated worse hearing in non-frequent users compared to frequent users. No significant differences in prevalence of high-frequency notches be- tween subgroups were noted. The outcomes do not support some previous studies results that the excessive exposure to music listened through PAPs might result in accelerating of development of NIHL loss in young adults.Keywords:
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Abstract Chronic tinnitus is often associated with hearing impairment, but it cannot be asserted that only hearing loss causes tinnitus. Audiograms of patients with tinnitus show that hearing loss occurred more often at high frequencies than at low frequencies. The aim of this study was to analyse the audiogram shapes of patients with chronic tinnitus and to identify the relationship between the shape of the audiogram and intensity and duration of tinnitus. This investigation was a cross case series study conducted at a general hospital in Kraljevo on patients with chronic subjective tinnitus. The study included 43 patients of both genders and of different ages. We used audiometry (measuring the threshold of hearing for frequencies from 250, 500, 1000, 2000, 4000 and 8000 Hz) and tympanometry. Each patient reported the intensity of tinnitus in each ear on a visual analogue scale (VAS 1 ) and stated the duration of tinnitus for each ear. Our research showed that patients with chronic tinnitus had a characteristic audiogram with progressive hearing loss to high frequencies. Th is difference was significantly increased starting from lower to higher frequencies, and the most hearing-decreased range (“edge”) was between 2000 and 4000 Hz. We did not find a strong link between the tinnitus intensity measured by the visual analogue scale and tinnitus duration on one side and hearing loss in the studied patients and audiogram shape on the other side. The duration of tinnitus was most associated with hearing loss at 2000 Hertz, but even that was not significant.
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To understand the presenting auditory signs and symptoms and to examine the relationship between the auditory manifestations and audiometric parameters in superior semicircular canal dehiscence (SSCD).Twenty consecutive patients with unilateral SSCD without a history of previous ontologic surgery.Relationship between presenting symptoms and the bone-conduction thresholds and air-bone gap (ABG) on pure-tone audiometry.All 20 patients presented with typical vestibular symptoms of SSCD. Seventeen (85%) patients also had auditory symptoms, including autophony (40%), hyperacusis to bodily sounds (65%), hearing loss (40%), aural pressure (45%), and tinnitus (35%). Of the 17 patients, 14 (82%) patients had an ABG on audiometry, but only 7 (41%) patients demonstrated negative bone conduction thresholds. Of 8 patients, 5 who underwent surgical repair experienced resolution of autophony and/or hyperacusis postoperatively.Auditory symptoms are common in SSCD patients. These symptoms do not show any relationship to the presence of negative bone-conduction thresholds on pure-tone audiometry. No firm conclusion could be drawn regarding the association between symptoms and ABG. Different pathways or mechanisms may exist in SSCD for bone-conducted sounds arising from different sources. Surgical repair of the dehiscence results in resolution of auditory symptoms in most patients.
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The tinnitus spectrum is a psycho-acoustic metric of tinnitus. Previous work found a tight relation between the spectrum and the tone audiogram. This suggests that the spectrum and the audiogram provide essentially the same information, and the added value of the spectrum is limited. In order to test whether the spectrum shows tinnitus characteristics that cannot be inferred from the audiogram, we re-examined the relation between the tinnitus spectrum and the tone audiogram, in a group of 80 tinnitus patients. We defined three subgroups of patients, using the shape of their tinnitus spectrum: (1) patients with a spectrum, monotonously increasing with frequency (2) patients with a distinct peak in their spectrum, (3) all other patients. Patients in group 3 typically showed low frequency tinnitus spectra. In all three groups, the largest hearing loss was at high frequencies (>2 kHz). The mean audiograms of group 1 and 2 were remarkably similar; group 3 had an additional hearing loss for the lower frequencies (<2 kHz). The three groups did not differ with respect to age, sex, or tinnitus questionnaire outcomes. In subgroups 2 and 3, the shape of the spectrum clearly differed from that of the tone audiogram. In other words, the spectrum technique provided information that could not have been obtained by tone audiometry alone. Therefore, the spectrum measurement may develop into a technique that can differentiate between classes of tinnitus. This may eventually contribute to the effective management of tinnitus, as various classes of tinnitus may require different therapeutic interventions.
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Although tinnitus represents a major global burden, no causal therapy has yet been established. Ongoing controversies about the neuronal pathophysiology of tinnitus hamper efforts in developing advanced therapies. Hypothesizing that the unnoticed co-occurrence of hyperacusis and differences in the duration of tinnitus may possibly differentially influence the neural correlate of tinnitus, we analyzed 33 tinnitus patients without (T-group) and 20 tinnitus patients with hyperacusis (TH-group). We found crucial differences between the T-group and the TH-group in the increase of annoyance, complaints, tinnitus loudness, and central neural gain as a function of tinnitus duration. Hearing thresholds did not differ between T-group and TH-group. In the TH-group, the tinnitus complaints (total tinnitus score) were significantly greater from early on and the tinnitus intensity distinctly increased over time from ca. 12 to 17 dB when tinnitus persisted more than 5 years, while annoyance responses to normal sound remained nearly constant. In contrast, in the T-group tinnitus complaints remained constant, although the tinnitus intensity declined over time from ca. 27 down to 15 dB beyond 5 years of tinnitus persistence. This was explained through a gradually increased annoyance to normal sound over time, shown by a hyperacusis questionnaire. Parallel a shift from a mainly unilateral (only 17% bilateral) to a completely bilateral (100%) tinnitus percept occurred in the T-group, while bilateral tinnitus dominated in the TH-group from the start (75%). Over time in the T-group, ABR wave V amplitudes (and V/I ratios) remained reduced and delayed. By contrast, in the TH-group especially the ABR wave III and V (and III/I ratio) continued to be enhanced and shortened in response to high-level sound stimuli. Interestingly, in line with signs of an increased co-occurrence of hyperacusis in the T-group over time, ABR wave III also slightly increased in the T-group. The findings disclose an undiagnosed co-occurrence of hyperacusis in tinnitus patients as a main cause of distress and the cause of complaints about tinnitus over time. To achieve urgently needed and personalized therapies, possibly using the objective tools offered here, a systematic sub-classification of tinnitus and the co-occurrence of hyperacusis is recommended.
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Objective Determine if somatic tinnitus patients with hyperacusis have different characteristics from those without hyperacusis. Patients and methods 172 somatic tinnitus patients with (n = 82) and without (n = 90) hyperacusis referred to the Tinnitus Unit of Sapienza University of Rome between June 2012 and June 2016 were compared for demographic characteristics, tinnitus features, self-administered questionnaire scores, nature of somatic modulation and history. Results Compared to those without hyperacusis, patients with somatic tinnitus and hyperacusis: (a) were older (43.38 vs 39.12 years, p = 0.05), (b) were more likely to have bilateral tinnitus (67.08% vs 55.56%, p = 0.04), (c) had a higher prevalence of somatic modulation of tinnitus (53.65% vs 36.66%, p = 0.02) and (d) scored significantly worse on tinnitus annoyance (39.34 vs 22.81, p<0.001) and subjective hearing level (8.04 vs 1.83, p<0.001). Conclusion Our study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis. These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients.
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Summary Introduction: High-frequency audiometry is not usually carried out during routine hearing examinations. It is a frequently used method at the ENT Clinic of the University Hospital Motol (especially in patients being treated for tumours of the pontocerebellar angle), although the exact indicative criteria for this have not been determined. We aimed to characterize a group of patients, using a method which improved the accuracy of the diagnostics. Material and methodology: We analysed 1,515 audiograms retrospectively. These audiograms were performed by using audiometer MADSEN Astera of GN Otometrics during 2011–2018 in 773 adults, aged 16–80 (47.79 ±13.54). They all underwent high-frequency audiometry comprising of all commonly examined frequencies up to 8 kHz, and also at higher frequencies of – 9 kHz, 10 kHz, 11.2 kHz, 12.5 kHz, 14 kHz a 16 kHz. The indication was very diverse – subjective hypacusis/hyperacusis, tinnitus, vestibulopathy, acutrauma, or an already known diagnosis of a pontocerebellar tumour. Results: We identifi ed a clinically signifi cant asymmetry or pathological elevation of the hearing threshold, which was only detectable at frequencies above 8 kHz in 52 patients (6.73%). This group consisted of patients with vestibular schwannoma (48.08%), other tumours and vascular malformations of the temporal region (11.53%), vestibulopathy (3.85%), and patients that had never developed a serious pathology (23.08%). They were mostly patients with straightforward hypacusis or tinnitus. Conclusion: In clinical practice, there are cases of patients with a hearing defect that can only be detected when HFA is performed. HFA clarifi es the diagnosis of hearing disorders and can lead to the detection of potentially life-threatening conditions such as tumours and vascular malformations of the otological area. Key words high-frequency audiometry – hearing loss – tinnitus
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The patients with tinnitus and/or hyperacusis undergoing an 18-24 month period of TRT are divided into five categories of treatment. Different types of counselling and sound therapy are used in each category. Selection of patients into a specific category depends on such factors as: hyperacusis, subjective hearing loss and long-lasting effect of noise on tinnitus. The 108 cases were evaluated After 1 year of treatment. The results of therapy of 40 patients with tinnitus and subjective hearing loss (category II) were compared with the results of therapy of patients with tinnitus only (categories 0 and I). A special questionnaire, answered before and during the treatment, was used to assess the results. Our data indicate significant improvement in about 70% of patients with tinnitus only and in about 90% of patients with tinnitus and subjective hearing loss after one year of therapy.
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