Building a Multidisciplinary Cochlear Implant Team

Cochlear implantation is evolving into a common modality of auditory rehabilitation for the patient with severe to profound sensorineural hearing loss. In order to provide the patient considering cochlear implantation with an understanding of how best to integrate the device into his daily life, adequate evaluation, counseling, and instruction are required. Using the multidisciplinary model, our initial experience has shown that evaluation by specialists in audiology, otolaryngology, speech pathology, pediatric genetics, social work, and child life may lead to better patient and family understanding of cochlear implantation.

Sleep Apnea Is Associated with Hearing Impairment: The Hispanic Community Health Study/Study of Latinos

Sleep apnea (SA) may promote hearing impairment (HI) through ischemia and inflammation of the cochlea. Our objective was to assess an independent association between SA and HI in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants

Hearing Impairment Prevalence and Associated Risk Factors in the Hispanic Community Health Study/Study of Latinos

Hearing impairment (HI) is a common problem in adults but there have been few studies of hearing in the U.S. Hispanic/Latino population. Little is known about factors associated with HI among Hispanics/Latinos

Attentional Resources Are Needed for Auditory Stream Segregation in Aging

The ability to select sound streams from background noise becomes challenging with age, even with normal peripheral auditory functioning. Reduced stream segregation ability has been reported in older compared to younger adults. However, the reason why there is a difference is still unknown. The current study investigated the hypothesis that automatic sound processing is impaired with aging, which then contributes to difficulty actively selecting subsets of sounds in noisy environments. We presented a simple intensity oddball sequence in various conditions with irrelevant background sounds while recording EEG. The ability to detect the oddball tones was dependent on the ability to automatically or actively segregate the sounds to frequency streams. Listeners were able to actively segregate sounds to perform the loudness detection task, but there was no indication of automatic segregation of background sounds while watching a movie. Thus, our results indicate impaired automatic processes in aging that may explain more effortful listening, and that tax attentional systems when selecting sound streams in noisy environments

Evaluation of Esterified Hyaluronic Acid as Middle Ear–Packing Material

OBJECTIVE To evaluate the efficacy of esterified hyaluronic acid (MeroGel) as a middle ear (ME)–packing material. DESIGN Randomized controlled trial. MATERIAL Twenty-four guinea pigs. INTERVENTION Group 1, MeroGel-treated animals (n = 10), bilateral wounding of ME mucosa with 5 of the animals receiving the MeroGel packing in the left ME and 5 of the animals receiving MeroGel in the right ME; group 2, absorbable gelatin sponge–treated animals (n = 10), with the same experimental protocol as in group 1 except that the absorbable gelatin sponge was the packing material; group 3, untreated animals (n = 4), unilateral wounding of the left ME mucosa in 2 animals and in 2 animals in the right ME, with no packing material. Auditory brainstem recordings were performed for all groups before the ME operation and 5 days and 6 weeks after the operation. RESULTS Auditory brainstem response recordings at postoperative day 5 showed that all ears with ME packing had hearing losses in the frequency range of 500 to 4000 Hz. The recovery of hearing acuity at postoperative week 6 was significantly better in group 1 (MeroGel-treated) guinea pigs compared with group 2 (the absorbable gelatin sponge–treated) animals. In group 2 animals, 20% of the packing material remained in the ME cavities and new bone formation was observed, while in group 1 animals, there was less packing material in the ME and no formation of new bone. CONCLUSIONS MeroGel is a nonototoxic packing material with a high level of biocompatibility for ME mucosa; it is an effective supportive material following ME surgery and is easily expelled from the ME cavity.Arch Otolaryngol Head Neck Surg. 2001;127:534-539--

Abstract P006: Cardiovascular Disease Risk Factor Burden is Associated With Hearing Loss in Young Men: The Hispanic Community Health Study/Study of Latinos

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) 160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL

Risk factors for hearing impairment among adults with diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Aim: The aim was to examine risk factors for hearing impairment among Hispanic/Latino adults with diabetes. Methods: Findings are based on 3384 participants aged 18–76 years with diagnosed or previously undetected diabetes who completed audiometric testing as part of the Hispanic Community Health Study/Study of Latinos. We defined hearing impairment as the pure-tone average (PTA) >25 decibels hearing level [dB HL] of pure-tone thresholds at high frequencies (3000, 4000, 6000, and 8000 Hz) in the worse ear and defined a second hearing impairment outcome with the additional requirement of PTA >25 dB HL of low/mid-frequency (500, 1000, and 2000 Hz) thresholds in the worse ear. We identified independent associations using logistic regression. Results: Controlling for age and Hispanic/Latino background, prevalence ratios for hearing impairment in the high plus low/mid frequencies were 1.35 (95% CI 1.07, 1.71) for current smoking, 1.64 (1.14, 2.38) for alcohol consumption (≥14 drinks/week for men or ≥ 7 drinks/week for women), and 1.29 (1.06, 1.56) for triglycerides ≥ 150 mg/dL. For high-frequency only hearing impairment, the prevalence ratio for estimated glomerular filtration rate 30–59 mL/min/1.73 m2 was 1.23 (1.03, 1.47) adjusted for age and sex. People with family income less than $20,000 had almost twice the prevalence of hearing impairment (PR = 1.93 (1.34, 2.78)) as people with income over$40,000. Conclusions: Current smoking, alcohol consumption, high triglycerides, and chronic kidney disease are potentially preventable correlates of hearing impairment for persons with diabetes. Low income is a marker of increased likelihood of hearing impairment

Hearing Impairment Prevalence and Associated Risk Factors in the Hispanic Community Health Study/Study of Latinos

IMPORTANCE: Hearing impairment (HI) is a common problem in adults but there have been few studies of hearing in the U.S. Hispanic/Latino population. Little is known about factors associated with HI among Hispanics/Latinos. OBJECTIVE: To determine the prevalence of HI among U.S. Hispanic/Latino adults of diverse backgrounds and determine associations with sociodemographic factors, noise exposure, diabetes, smoking, cardiovascular disease, and other potential risk factors. DESIGN AND SETTING: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a population-based sample of Hispanics/Latinos in four U.S. communities (Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA). Examinations were conducted in 2008–2011. PARTICIPANTS: The HCHS/SOL examined 16,415 self-identified Hispanic/Latino persons aged 18 to 74 years recruited from randomly selected households using a stratified 2-stage area probability sample design based on census block groups and households within block groups. INTERVENTION(S): None MAIN OUTCOME(S) AND MEASURES: Hearing thresholds were measured by pure-tone audiometry. HI was defined as a pure-tone average (PTA) of thresholds at 0.5,1,2,4 kHz >25 dB HL. Bilateral hearing impairment (BHI) required a PTA>25 dB HL in both ears. Multivariable analyses included adjustments for sociodemographic and lifestyle variables, body mass index, and medical conditions. RESULTS: The prevalence of HI was 15.1% overall and 8.2% had BHI. The prevalence of HI was higher among people aged 45 and older, ranging by Hispanic/Latino background from 29–41% among men and 18–31% among women. The multivariable-adjusted odds of HI was greater for participants of Puerto Rican background compared to Mexican background (OR =1.57, 95%CI=1.10, 2.25). The odds of HI were lower with more education and higher income. People with noise exposure were about 30% more likely to have HI. Diabetes (OR=1.57, 95%CI= 1.27, 1.94) and pre-diabetes (OR=1.37, 95%CI= 1.12, 1.67) were associated with higher odds of HI. CONCLUSIONS AND RELEVANCE: HI is a common problem for older Hispanics/Latinos in these communities and is associated with socioeconomic factors, noise exposure and abnormal glucose metabolism. Longitudinal studies are needed to determine if these factors are involved in the etiology of HI and to identify ways to prevent or delay age-related changes in hearing