中文版hearWHO应用程序在听力筛查中的验证

目的验证中文版hearWHO应用程序,一款噪声下数字言语测试工具,在听力筛查中的有效性。方法招募听力正常者12名,听力损失患者92例。所有受试者依次完成纯音听阈测试、声导抗测试以及中文版hearWHO测试。分析双耳PTA0.5~4kHz和hearWHO得分的相关性,采用受试者工作特性曲线及曲线下面积等参数,确定hearWHO得分在最佳诊断截点下的灵敏度和特异度。结果hearWHO得分与较好耳和较差耳纯音听阈均值PTA0.5~4kHz均呈显著负相关性,相关系数分别为-0.552和-0.693(P<0.001)。按PTA0.5~4kHz≥20dBHL为存在听力损失的标准,当hearWHO得分≤60时,提示至少单耳出现听力下降,灵敏度和特异度分别为0.733、0.690;当hearWHO得分≤50时,提示受试者可能存在双耳听力下降,灵敏度和特异度分别为0.815、0.917。结论hearWHO对检出单耳或双耳听力损失的灵敏度和特异度均较高,当hearWHO得分≤60时,提示受试者有必要转诊进行进一步的听力检测及诊断。

Genetically modified pigs:Emerging animal models for hereditary hearing loss

Hereditary hearing loss(HHL),a genetic disorder that impairs auditory function,significantly affects quality of life and incurs substantial economic losses for society.To investigate the underlying causes of HHL and evaluate therapeutic outcomes,appropriate animal models are necessary.Pigs have been extensively used as valuable large animal models in biomedical research.In this review,we highlight the advantages of pig models in terms of ear anatomy,inner ear morphology,and electrophysiological characteristics,as well as recent advancements in the development of distinct genetically modified porcine models of hearing loss.Additionally,we discuss the prospects,challenges,and recommendations regarding the use pig models in HHL research.Overall,this review provides insights and perspectives for future studies on HHL using porcine models.

Universal newborn hearing screening program in Saudi Arabia: Current insight

Newborn hearing screening(NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016;however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.

Ionically Imprinting-Based Copper(Ⅱ)Label-Free Detection for Preventing Hearing Loss

Copper is a microelement with important physiological functions in the body.However,the excess copper ion(Cu^(2+))may cause severe health problems,such as hair cell apoptosis and the resultant hearing loss.Therefore,the assay of Cu^(2+)is important.We integrate ionic imprinting technology(IIT)and structurally colored hydrogel beads to prepare chitosan-based ionically imprinted hydrogel beads(IIHBs)as a low-cost and high-specificity platform for Cu^(2+)detection.The IIHBs have a macroporous microstructure,uniform size,vivid structural color,and magnetic responsiveness.When incubated in solution,IIHBs recognize Cu^(2+)and exhibit a reflective peak change,thereby achieving label-free detection.In addition,benefiting from the IIT,the IIHBs display good specificity and selectivity and have an imprinting factor of 19.14 at 100μmol·L^(-1).These features indicated that the developed IIHBs are promising candidates for Cu^(2+)detection,particularly for the prevention of hearing loss.

Navigating Silence: A Comprehensive Review of Parental Roles in the Rehabilitation of Children with Hearing Loss

This narrative literature review delves into the multifaceted realm of parental involvement in the rehabilitation of children with permanent hearing loss. While existing research has made strides in elucidating parental roles in this context, critical gaps persist, necessitating a comprehensive exploration to inform future endeavors. Our review synthesizes a wide array of studies, identifying these gaps and emphasizing the significance of addressing them. Themes emerging from the literature include the varying degrees of parental engagement, the impact of cultural and socio-economic factors, and the challenges faced by families navigating rehabilitation processes. The synthesis of this literature not only highlights the current state of knowledge but also provides a roadmap for future research efforts. By addressing these gaps, we aim to contribute to a more nuanced understanding of parental involvement in the rehabilitation of children with permanent hearing loss, ultimately fostering improved support systems and holistic care for affected families.

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

Effect of foot reflexology on an infant with sensorineural hearing loss:A case report

BACKGROUND Our study contributes to the further understanding of the mechanism of foot reflexology.Foot reflexology has been reported to affect hearing recovery,but no physiological evidence has been provided.This lack of evidence hampers the acceptance of the technique in clinical practice.CASE SUMMARY A girl was taken to North Sichuan Medical University Affiliated Hospital for a hearing screen by her parents.Her parents reported that her hearing level was the same as when she was born.The girl was diagnosed with sensorineural hearing loss(SNHL)by a doctor in the otolaryngology department.After we introduced the foot reflexology project,the parents agreed to participate in the experiment.After 6 months of foot reflexology treatment,the hearing threshold of the girl recovered to a normal level,below 30 dB.CONCLUSION Foot reflexology should be encouraged in clinical practice and for families of infants with SNHL.

Prevalence of Noise-Induced Hearing Loss Related to the Mills in the Markets of the Municipality of Parakou in 2021

Introduction: Noise is the second leading cause of hearing loss in adults after presbycusis. The objective of this work was to study hearing loss induced by the noise of mills in the markets of Parakou. Methods: This was a descriptive and analytical cross-sectional study, conducted from February 3 to June 3, 2021 in the markets of Parakou. It concerned millers and sellers located within a 5 meter radius around the mills and among whom pure-tone audiometry was performed to detect a hearing loss. Subjects with no particular medical health history, under 55 years of age and having been working in these markets since more than 12 months, were included. Results: In this study, 103 subjects were selected, including 43 millers and 61 sellers. Their average age was 29 ± 13 years. The sex ratio was 0.49. The average length of service in the profession was 8 years with the extremes of 3 months and 47 years. They were exposed to noise on average 10 hours per day and 6 days a week. The average duration of weekly noise exposure was 23 h 28 min ± 13 h 32 min with the extremes of 5 h 00 min and 52 h 30 min. The average level of noise exposure was 90 dB with the extremes of 72 and 110 dB. 24 subjects reported symptoms related to noise such as headache, tinnitus, and hearing loss, with respective proportions of 22.33%, 20.39% and 06.80%. The prevalence of noise-related hearing loss was 26.21% (n = 27/103). Subjects with a notch at 4000 Hz and normal Average Hearing Loss (AHL) (20.39%) had a seven-time greater risk of developing noise-induced hearing loss (OR = 6.58;95% CI [2.54 - 18.8], p Conclusion: Hearing loss related to the noise of mills affected both millers and sellers near the mills in markets, hence the importance of regulating mills.

Clinical characteristics and analysis of vestibular-evoked myogenic potentials in patients with sudden sensorineural hearing loss in different ages

BACKGROUND Numerous studies have found that patients experiencing sudden sensorineural hearing loss(SSHL),with or without accompanying vertigo,often show impaired vestibular function.However,there is a dearth of studies analyzing vestibularevoked myogenic potentials(VEMPs)in SSHL patients across various age groups.AIM To investigate vestibular condition in SSHL patients across various age demographics.METHODS Clinical data of 84 SSHL patients were investigated retrospectively.Audiometry,cervical vestibular evoked myogenic potentials(c-VEMPs),and ocular vestibular evoked myogenic potentials(o-VEMPs)were conducted on these patients.Parameters assessed included the latencies of P1 and N1 waves,as well as the amplitudes of P1–N1 waves.Moreover,the study evaluated the influence of factors such as sex,affected side,configuration of hearing loss,and presence of accompanying vertigo.RESULTS Among the 84 SSHL patients,no significant differences were observed among the three groups in terms of gender,affected side,and the presence or absence of vertigo.Group II(aged 41–60 years)had the highest number of SSHL cases.The rates of absent o-VEMPs in the affected ears were 20.83%,31.58%,and 22.72%for the three age groups,respectively,with no statistically significant difference among them.The rates of absent c-VEMPs in the affected ears were 8.3%,34.21%,and 18.18%for the three age groups,respectively,with significant differences.In the unaffected ears,there were differences observed in the extraction rates of o-VEMPs in the unaffected ears among the age groups.In the three age groups,no significant differences were noted in the three age groups in the latencies of P1 and N1 waves or in the amplitude of N1–P1 waves for c-VEMPs and o-VEMPs,either on the affected side or on the unaffected side,across the three age groups.CONCLUSION The extraction rate of VEMPs is more valuable than parameters.Regardless of the presence of vertigo,vestibular organs are involved in SSHL.Notably,SSHL patients aged 41–60 appear more susceptible to damage to the inferior vestibular nerve and saccule.

Effects of Drilling in Mastoid Cavity over Hearing in the Contralateral Ear

In advanced otological surgeries, powered instruments form an indispensable part. The risk of deterioration to hearing in the operated ear is a commonly discussed issue, however, there remains a possibility of affecting the hearing in the contralateral ear due to transcranial vibration. So in this study we aimed to assess the possibility of the non-operated ear being affected by the noise generated during ear surgeries and whether it is temporary or permanent in nature. Methodology: This study included 63 patients diagnosed with unilateral disease who underwent mastoid surgery. Preoperatively all the patients were subjected to Pure tone audiometry (PTA), Transient evoked otoacoustic emission (TEOAE) and Distortion product otoacoustic emission (DPOAE). Patients were operated using both cutting and diamond burrs of ranging from sizes 1 - 6 mm. Total drilling time was recorded. Results: Post-operative hearing evaluation was done at 1 week, 4 weeks and 12 weeks. The sound emitted by various burrs was recorded by Sound Level Meter. Out of the total 58 patients that followed up, 46 showed change in at least one of the hearing parameters. Patients showing changes had a higher drilling time as compared to those with no changes. Of these, the changes associated with the total drilling time and with cutting burr time were found to be significant. The hearing changes seen on PTA, TEOAE and DPOAE were transient in nature with only one patient having a persistent decreased high frequency threshold at the end of 12 weeks. It was also found that cutting burrs produce more sound as compared to diamond burrs and a larger size burr of a type produces more sound than a smaller one of its type. Conclusion: The drilling of mastoid bone during ear surgeries can transiently impair the hearing in the contralateral ear which is of great significance in patients with only one hearing ear.

Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid-to high-frequency sudden sensorineural hearing loss

BACKGROUND Sudden sensorineural hearing loss(SSNHL),characterized by a rapid and unexplained loss of hearing,particularly at moderate to high frequencies,presents a significant clinical challenge.The therapeutic use of methylprednisolone sodium succinate(MPSS)via different administration routes,in combination with conventional medications,remains a topic of interest.AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid-to high-frequency SSNHL.METHODS The medical records of 109 patients with mid-to high-frequency SSNHL were analyzed.The patients were divided into three groups based on the route of administration:Group A[intratympanic(IT)injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection],Group B(intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection),and Group C(single IT injection of MPSS).The intervention effects were compared and analyzed.RESULTS The posttreatment auditory thresholds in Group A(21.23±3.34)were significantly lower than those in Groups B(28.52±3.36)and C(30.23±4.21;P<0.05).Group A also exhibited a significantly greater speech recognition rate(92.23±5.34)than Groups B and C.The disappearance time of tinnitus,time to hearing recovery,and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C(P<0.05).The total effective rate in Group A(97.56%)was significantly greater than that in Groups B and C(77.14%and 78.79%,χ^(2)=7.898,P=0.019).Moreover,the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B(4.88%,3.03%vs 2.57%,χ^(2)=11.443,P=0.003),and the recurrence rate in Group A was significantly lower than that in Groups B and C(2.44%vs 20.00%vs 21.21%,χ^(2)=7.120,P=0.028).CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS.This approach effectively improves patients'hearing and reduces the risk of disease recurrence.

Tranylcypromine upregulates Sestrin 2 expression to ameliorate NLRP3-related noise-induced hearing loss

Noise-induced hearing loss is the primary non-genetic factor contributing to auditory dysfunction.However,there are currently no effective pharmacological interventions for patients with noise-induced hearing loss.Here,we present evidence suggesting that the lysine-specific demethylase 1 inhibitor–tranylcypromine is an otoprotective agent that could be used to treat noise-induced hearing loss,and elucidate its underlying regulatory mechanisms.We established a mouse model of permanent threshold shift hearing loss by exposing the mice to white broadband noise at a sound pressure level of 120 d B for 4 hours.We found that tranylcypromine treatment led to the upregulation of Sestrin2(SESN2)and activation of the autophagy markers light chain 3B and lysosome-associated membrane glycoprotein 1 in the cochleae of mice treated with tranylcypromine.The noise exposure group treated with tranylcypromine showed significantly lower average auditory brainstem response hearing thresholds at click,4,8,and 16 k Hz frequencies compared with the noise exposure group treated with saline.These findings indicate that tranylcypromine treatment resulted in increased SESN2,light chain 3B,and lysosome-associated membrane glycoprotein 1 expression after noise exposure,leading to a reduction in levels of 4-hydroxynonenal and cleaved caspase-3,thereby reducing noise-induced hair cell loss.Additionally,immunoblot analysis demonstrated that treatment with tranylcypromine upregulated SESN2 expression via the autophagy pathway.Tranylcypromine treatment also reduced the production of NOD-like receptor family pyrin domaincontaining 3(NLRP3)production.In conclusion,our results showed that tranylcypromine treatment ameliorated cochlear inflammation by promoting the expression of SESN2,which induced autophagy,thereby restricting NLRP3-related inflammasome signaling,alleviating cochlear hair cell loss,and protecting hearing function.These findings suggest that inhibiting lysine-specific demethylase 1 is a potential therapeutic strategy for preventing hair cell loss and noise-induced hearing loss.

Evaluation of Digits-in-Noise Test and Hearing Handicap Inventory for Adults Screening in Patients with Occupational Noise-Induced Hearing Loss

Objective:To explore the clinical evaluation role of the Digits-in-Noise(DIN)test and Hearing Handicap Inventory for Adults Screening(HHIA-S)for patients with occupational noise-induced hearing loss and to observe and analyze their application values.Methods:Fifty patients with suspected occupational noise-induced hearing loss were randomly selected from the Department of Otolaryngology at the hospital as the research target.The collection period for the research cases spanned from January 2022 to November 2023,and all patients had a history of noise exposure.The DIN test and HHIA-S were used for hearing examinations,with clinical,comprehensive diagnosis serving as the gold standard to study their diagnostic performance.Results:The compliance rate of the DIN test was 88.00%,the HHIA-S’s compliance rate was 80.00%,and the combined compliance rate was 94.00%.The compliance rate of the DIN test and the combined compliance rates of the patients were statistically significant compared to the clinical gold standard data(P<0.05),while there was no difference between the compliance rate of the HHIA-S and the gold standard(P>0.05).The data shows that the sensitivity of the combined diagnosis is significantly higher than the sensitivity data of the DIN test and HHIA-S examination alone(P<0.05).Its specificity is 100.00%,and the accuracy data of the joint diagnosis in the degree were higher than those of the DIN test alone(P>0.05)and the HHIA-S alone(P<0.05).Conclusion:For patients with occupational noise-induced hearing loss,the joint evaluation of the DIN test and HHIA-S can significantly improve their diagnostic value with high sensitivity and accuracy.

某冶金制造企业噪声暴露对听力水平的影响

目的探讨冶金制造业噪声暴露对听力水平的影响。方法对某企业245名噪声暴露工人及51名行政人员进行双耳0.5~8 kHz纯音气导听阈测试,检测工作场所噪声8 h等效声级,统计分析不同工种工人听力阈值。结果噪声暴露工人0.5~8 kHz听力阈值均显著高于行政人员;听力受损主要发生在4、6 kHz;听力阈值与工龄、年龄正相关,40岁以上、6年以上工龄,工人双耳4、6 kHz听力阈值均高于40 dB HL。结论噪声暴露工人4、6 kHz听力损伤最明显,年龄、工龄、噪声暴露强度是听力受损的危险因素。应加强噪声源的控制,重视耳塞等防护措施,并减少噪声暴露时间。

隐性听力损失中医病机及防治研究进展

隐性听力损失是以纯音听阈正常,噪声背景下言语识别能力降低为主要症状的疾病,噪声暴露、药物损伤、年龄老化是主要的致病危险因素,其发病隐匿,容易忽视,危险因素持续暴露可造成不可逆听力损伤,目前临床多无有效的治疗方法,以早期预防为主。根据隐性听力损失的致病因素及发病机制,探讨隐性听力损失的中医病机,认为脾虚湿滞、清窍蒙蔽、肾元不足、邪聚耳窍为致病的内在因素,毒邪犯耳、内毒留滞、毒瘀经络为病理机制,并对近年来隐性听力损失的预防与治疗研究概况做一总结,为中医药治疗隐性听力损失研究提供理论依据和临床经验。

宁波方言版数字三联音测试在听力筛查中的应用研究

目的 探究宁波方言版数字三联音测试(digit triplet test,DTT)在听力筛查中的敏感性和特异性,同时探索平均听阈、教育程度、年龄、认知能力等因素对宁波方言版DTT的影响。方法 选取2022年9月—2023年6月宁波卫生职业技术学院青年受试者23例为青年组、同期以宁波方言为母语的老年受试者33例为老年组。青年组完成宁波方言版DTT、普通话版DTT。老年组完成纯音测试、方言版DTT、中文版蒙特利尔认知评估基础量表测试,10例老年组同时完成普通话版DTT。结果 青年组普通话版DTT噪声下言语识别阈(speech reception threshold,SRT)与宁波方言版DTT比较,差异无统计学意义(P>0.05);老年组普通话版DTT的SRT与宁波方言版DTT比较,差异有统计学意义(P<0.05)。受试者教育程度、年龄均与宁波方言版DTT的SRT无相关。以25 dB HL作为宁波方言版测试的筛查目标时,SRT最佳截断分数-7.7分,筛查敏感性87.0%,特异性90.9%;以35 dB HL作为筛查目标时,SRT最佳截断分数为-7.7分,敏感性100.0%,特异性97.5%。结论 宁波地区老年人需要方言版的听力筛查工具,宁波方言版DTT具备实现宁波地区开展大范围的听力筛查的潜力,建议筛查目标设为35 dB HL。

多种听力学检测方法在未引出听性脑干反应患儿诊断中的价值

目的探讨多种听力学检测方法在听性脑干反应(ABR)最大输出未引出患儿的听力学诊断中的应用价值。方法回顾性分析69例(138耳)ABR最大强度未引出患儿的临床资料,年龄42天到5岁,平均1岁6个月,鼓室导抗图均为A型或正向单峰,声反射均未引出,影像学检查内耳无畸形。69例患儿均进行ABR、耳蜗微音电位(CM)、畸变产物耳声发射(DPOAE)和听性稳态反应(ASSR)测试。结果69例138耳中,8例16耳(11.59%)记录到CM,其中10耳(7.25%)记录到DPOAE,0.5、1、2、4 kHz ASSR反应阈值分别为83.2±13.1、82.9±13.0、75.3±12.4、63.1±9.1 dB nHL,结合其他检查结果诊断为听神经病。余61例(122耳)CM和DPOAE均未引出,0.5、1、2、4 kHz的ASSR引出率分别为82.3%、81.9%、76.9%、60.2%,其中20耳ASSR各频率均未引出,102耳至少一个频率引出,0.5、1、2、4 kHz ASSR反应阈分别为93.2±6.1、99.8±7.0、105.4±5.4、108.2±9.8 dB nHL,诊断为极重度感音神经性聋。结论对于ABR最大输出强度未引出的患儿,CM和/或DPOAE引出且ASSR各频率反应阈低于感音神经性聋患儿,有助于听神经病的诊断;CM和DPOAE均未引出有助于极重度感音神经性聋的诊断,ASSR测试有助于评估其残余听力。

基于ICF的听力障碍儿童言语与语言康复服务:理论架构与服务体系

目的 基于《国际功能、残疾和健康分类》(ICF)的生物-心理-社会功能和健康模式,系统分析世界卫生组织(WHO)康复相关的政策文件,探讨听力障碍儿童言语与语言康复的理论与政策原则、服务体系以及优先发展领域、主要政策和技术措施。方法 采用文献研究和政策研究法,系统梳理ICF的功能和健康架构、WHO康复相关政策报告和美国语言听力协会技术文件,结合我国听障儿童康复服务的现状和需求,提出构建基于ICF的听障儿童言语与语言康复服务体系的理论框架、优先领域和主要政策与技术措施。结果 发展听障儿童言语与语言康复需要遵循八大原则:以儿童为中心、尊重个体差异;全生命周期支持和促进持续发展;开展循证实践,确保干预的科学性和有效性;多学科团队合作并提供全面支持;构建家庭参与的支持网络;促进儿童的融合教育与社会参与;关注文化敏感性;技术赋能康复创新。听障儿童言语与语言康复要构建五大服务体系:早期筛查、诊断与干预综合体系;家庭和社会支持体系;多学科团队服务体系;全方位、多层次的听障儿童言语与语言康复服务体系;数字赋能服务构建新的康复服务模式。并讨论了优先发展领域以及主要政策和技术措施。结论 基于ICF的生物-心理-社会的功能和健康架构,通过加强政策支持、完善服务体系、构建多学科团队服务、推广数字赋能技术、加强社会支持等措施,可以为听障儿童提供全方位、个性化、持续性的高质量、全覆盖康复服务,促进儿童的全面发展和社会参与,提高儿童的生活质量。

世界范围听力保健(W.W.Hearing)的建立及我们的应答思路

《发展中国家助听器及其服务指南》是WHO第一份有关耳鼻咽喉科和听力学的正式中文文件。该文无疑给我国听力语言康复领域的发展带来了空前的机遇,同时我们也面临着严峻的国际竞争和国内多边协调的挑战。 为此,本刊特别约请卜行宽教授针对我国具体国情撰写专稿,解析该指南将产生的积极意义。

听力学工作中的标准化要求

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