Ear and Hearing最新文献

Objectives: Hispanic/Latino adults are less likely than non-Hispanic White adults to seek treatment for hearing disability. While differential socioeconomic factors may contribute to this finding, differences in phonology and syntax in the Spanish, versus English, language may also influence patient perception of hearing disability. The objective of this study is to investigate the association between primary language spoken and participant perception of hearing disability.

Design: This study represents a cross-sectional cohort study using National Health and Nutrition Examination Study cycles 2015-2016 and 2017-2020 data. Multivariable logistic regressions estimated the association between respondent-selected interview language, which was used as a proxy for primary spoken language, and participant perception of hearing disability. Models were adjusted for age, gender, highest degree of education, pure-tone average, and self-reported general health. Participants included 4687 individuals from the United States population who elected to speak English (n = 4083) or Spanish (n = 604) during the interview. Perception of hearing disability was assessed by (1) frequency of reported difficulty in following a conversation in noise, (2) frequency with which hearing caused respondents to experience frustration when talking with members of their family or friends, and (3) participants' subjective overall assessment of their hearing.

Results: Speaking Spanish, versus English, as a primary language was associated with a 42% lower odds of reporting difficulty hearing and understanding in background noise (odds ratio [OR]: 0.58, 95% confidence interval [CI]: 0.48 to 0.70). Spanish speakers had 28% lower odds of reporting feeling frustrated when talking to family members or friends due to hearing (OR: 0.72, 95% CI: 0.59 to 0.88) as compared with the English-speaking cohort. Speaking Spanish additionally conferred 31% lower odds of describing their own general hearing as "a little trouble to deaf" than participants speaking English (OR: 0.69, 95% CI: 0.53 to 0.90). These observed associations were independent of age, gender, highest degree of education, better pure-tone average? and self-reported general health.

Conclusions: Primary Spanish speakers may be less likely than English speakers to report hearing-related disability, an effect which may be independent of ethnicity. Patient perception of hearing-related disability is an important component of the assessment of and counseling for hearing-related disability and discussion of the need for amplification or other hearing intervention.

Objectives: Electrocochleography (ECochG) is increasingly recognized as a biomarker for assessing inner ear function in cochlear implant patients. This study aimed to objectively determine intraoperative cochlear microphonic (CM) amplitude patterns and correlate them with residual hearing in cochlear implant recipients, addressing the limitations in current ECochG analysis that often depends on subjective visual assessment and overlook the intracochlear measurement location.

Design: In this prospective study, we investigated intraoperative pure-tone ECochG following complete electrode insertion in 31 patients. We used our previously published objective analysis method to determine the maximum CM amplitude and the associated electrode position for each electrode array. Using computed tomography, we identified electrode placement and determined the corresponding tonotopic frequency using Greenwood's function. Based on this, we calculated the tonotopic shift, that is, the difference between the stimulation frequency and the estimated frequency of the electrode with the maximum CM amplitude. We evaluated the association between CM amplitude, tonotopic shift, and preoperative hearing thresholds using linear regression analysis.

Results: CM amplitudes showed high variance, with values ranging from -1.479 to 4.495 dBµV. We found a statistically significant negative correlation ( ) between maximum CM amplitudes and preoperative hearing thresholds. In addition, a significant association ( ) between the tonotopic shift and preoperative hearing thresholds was observed. Tonotopic shifts of the maximum CM amplitudes occurred predominantly toward the basal direction.

Conclusions: The combination of objective signal analysis and the consideration of intracochlear measurement locations enhances the understanding of cochlear health and overcomes the obstacles of current ECochG analysis. We could show the link between intraoperative CM amplitudes, their spatial distributions, and preoperative hearing thresholds. Consequently, our findings enable automated analysis and bear the potential to enhance specificity of ECochG, reinforcing its role as an objective biomarker for cochlear health.

Objectives: This study investigated the efficiency of a multiplexed amplitude-modulated (AM) stimulus in eliciting auditory steady-state responses. The multiplexed AM stimulus was created by simultaneously modulating speech-shaped noise with three frequencies chosen to elicit different neural generators: 3.1, 40.1, and 102.1 Hz. For comparison, a single AM stimulus was created for each of these frequencies, resulting in three single AM conditions and one multiplex AM condition.

Design: Twenty-two bilaterally normal-hearing participants (18 females) listened for 8 minutes to each type of stimuli. The analysis compared the signal to noise ratios (SNRs) and amplitudes of the evoked responses to the single and multiplexed conditions.

Results: The results revealed that the SNRs elicited by single AM conditions were, on average, 1.61 dB higher than those evoked by the multiplexed AM condition ( p < 0.05). The single conditions consistently produced a significantly higher SNR when examining various stimulus durations ranging from 1 to 8 minutes. Despite these SNR differences, the frequency spectrum was very similar across and within subjects. In addition, the sensor space patterns across the scalp demonstrated similar trends between the single and multiplexed stimuli for both SNR and amplitudes. Both the single and multiplexed conditions evoked significant auditory steady-state responses within subjects. On average, the multiplexed AM stimulus took 31 minutes for the lower bound of the 95% prediction interval to cross the significance threshold across all three frequencies. In contrast, the single AM stimuli took 45 minutes and 42 seconds.

Conclusions: These findings show that the multiplexed AM stimulus is a promising method to reduce the recording time when simultaneously obtaining information from various neural generators.

Objectives: Adults with permanent hearing loss exhibit a reduced range of valence ratings in response to nonspeech sounds; however, the degree to which sound genre might affect such ratings is unclear. The purpose of this study was to determine if ratings of valence covary with sound genre (e.g., social communication, technology, music), or only expected valence (pleasant, neutral, unpleasant).

Design: As part of larger study protocols, participants rated valence and arousal in response to nonspeech sounds. For this study, data were reanalyzed by assigning sounds to unidimensional genres and evaluating relationships between hearing loss, age, and gender and ratings of valence. In total, results from 120 adults with normal hearing (M = 46.3 years, SD = 17.7, 33 males and 87 females) and 74 adults with hearing loss (M = 66.1 years, SD = 6.1, 46 males and 28 females) were included.

Results: Principal component analysis confirmed valence ratings loaded onto eight unidimensional factors: positive and negative social communication, positive and negative technology, music, animal, activities, and human body noises. Regression analysis revealed listeners with hearing loss rated some genres as less extreme (less pleasant/less unpleasant) than peers with better hearing, with the relationship between hearing loss and valence ratings being similar across genres within an expected valence category. In terms of demographic factors, female gender was associated with less pleasant ratings of negative social communication, positive and negative technology, activities, and human body noises, while increasing age was related to a subtle rise in valence ratings across all genres.

Conclusions: Taken together, these results confirm and extend previous findings that hearing loss is related to a reduced range of valence ratings and suggest that this effect is mediated by expected sound valence, rather than sound genre.

Objectives: The inter-phase gap (IPG) offset effect is defined as the dB offset between the linear parts of electrically evoked compound action potential (ECAP) amplitude growth functions for two stimuli differing only in IPG. The method was recently suggested to represent neural health in cochlear implant (CI) users while being unaffected by CI electrode impedances. Hereby, a larger IPG offset effect should reflect better neural health. The aims of the present study were to (1) examine whether the IPG offset effect negatively correlates with the ECAP threshold and the preoperative pure-tone average (PTA) in CI recipients with residual acoustic hearing and (2) investigate the dependency of the IPG offset effect on hair cell survival and intracochlear electrode impedances.

Design: Seventeen adult study participants with residual acoustic hearing at 500 Hz undergoing CI surgery at the University Hospital of Zurich were prospectively enrolled. ECAP thresholds, IPG offset effects, electrocochleography (ECochG) responses to 500 Hz tone bursts, and monopolar electrical impedances were obtained at an apical, middle, and basal electrode set during and between 4 and 12 weeks after CI surgery. Pure-tone audiometry was conducted within 3 weeks before surgery and approximately 6 weeks after surgery. Linear mixed regression analyses and t tests were performed to assess relationships between (changes in) ECAP threshold, IPG offset, impedance, PTA, and ECochG amplitude.

Results: The IPG offset effect positively correlated with the ECAP threshold in intraoperative recordings ( p < 0.001) and did not significantly correlate with the preoperative PTA ( p = 0.999). The IPG offset showed a postoperative decrease for electrode sets that showed an ECochG amplitude drop. This IPG offset decrease was significantly larger than for electrode sets that showed no ECochG amplitude decrease, t (17) = 2.76, p = 0.014. Linear mixed regression analysis showed no systematic effect of electrode impedance changes on the IPG offset effect ( p = 0.263) but suggested a participant-dependent effect of electrode impedance on IPG offset.

Conclusions: The present study results did not reveal the expected relationships between the IPG offset effect and ECAP threshold values or between the IPG offset effect and preoperative acoustic hearing. Changes in electrode impedance did not exhibit a direct impact on the IPG offset effect, although this impact might be individualized among CI recipients. Overall, our findings suggest that the interpretation and application of the IPG offset effect in clinical settings should be approached with caution considering its complex relationships with other cochlear and neural health metrics.

Objectives: Noise risk control or management based on noise level has been documented, but noise risk management based on a combination of noise level and noise's temporal structure is rarely reported. This study aimed to develop a framework for industrial noise risk management based on noise kurtosis (reflecting noise's temporal structure) and its adjustment for the noise level.

Design: A total of 2805 Chinese manufacturing workers were investigated using a cross-sectional survey. The noise exposure data of each subject included L EX,8h , cumulative noise exposure (CNE), kurtosis, and kurtosis-adjusted L EX,8h (L EX,8h -K). Noise-induced permanent threshold shifts were estimated at 3, 4, and 6 kHz frequencies (NIPTS 346 ) and 1, 2, 3, and 4 kHz frequencies (NIPTS 1234 ). The prevalence of high-frequency noise-induced hearing loss prevalence (HFNIHL%) and noise-induced hearing impairment (NIHI%) were determined. Risk 346 or Risk 1234 was predicted using the ISO 1999 or NIOSH 1998 model. A noise risk management framework based on kurtosis and its adjustment was developed.

Results: Kurtosis could identify the noise type; Kurtosis combining noise levels could identify the homogeneous noise exposure group (HNEG) among workers. Noise kurtosis was a risk factor of HFNIHL or NIHI with an adjusted odds ratio of 1.57 or 1.52 ( p < 0.01). At a similar CNE level, the NIPTS 346 , HFNIHL%, NIPTS 1234 , or NIHI% increased with increasing kurtosis. A nonlinear regression equation (expressed by logistic function) could rebuild a reliable dose-effect relationship between L EX,8h -K and NIPTS 346 at the 70 to 95 dB(A) noise level range. After the kurtosis adjustment, the median L EX,8h was increased by 5.45 dB(A); the predicted Risk 346 and Risk 1234 were increased by 11.2 and 9.5%, respectively; NIPTS 346 -K of complex noise at exposure level <80, 80 to 85, and 85 to 90 dB(A), determined from the nonlinear regression equation, was almost the same as the Gaussian noise. Risk management measures could be recommended based on the exposure risk rating or the kurtosis-adjusted action levels (e.g., the lower and upper action levels were 80 and 85 dB(A), respectively).

Conclusions: The kurtosis and its adjustment for noise levels can be used to develop an occupational health risk management framework for industrial noise. More human studies are needed to verify the risk management framework.