Occupational Noise, Smoking, and a High Body Mass Index are Risk Factors for Age-related Hearing Impairment and Moderate Alcohol Consumption is Protective: A European Population-based Multicenter Study

A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pure-tone average [PTA]) were collected and the participants filled out a questionnaire on environmental risk factors and medical history. People with a history of disease that could affect hearing were excluded. PTAs were adjusted for age and sex and tested for association with exposure to risk factors. Noise exposure was associated with a significant loss of hearing at high sound frequencies (>1 kHz). Smoking significantly increased high-frequency hearing loss, and the effect was dose-dependent. The effect of smoking remained significant when accounting for cardiovascular disease events. Taller people had better hearing on average with a more pronounced effect at low sound frequencies (<2 kHz). A high body mass index (BMI) correlated with hearing loss across the frequency range tested. Moderate alcohol consumption was inversely correlated with hearing loss. Significant associations were found in the high as well as in the low frequencies. The results suggest that a healthy lifestyle can protect against age-related hearing impairment

Carcinoma of Unknown Primary:Diagnostics and the Potential of Transoral Surgery

The topic of the unknown primary tumour in head and neck cancer (CUP) has been extensively studied. The increasing incidence of Human papillomavirus (HPV) related oropharyngeal squamous cell carcinoma (OPSCC) as well as the emerging role of transoral robotic surgery (TORS) has led to revision and evolution of diagnostic and treatment paradigms. The concept of tongue base mucosectomy (TBM) has gained its place in the diagnostic pathway. The most recent considerations are described herein with regard to recent literature. An algorithm for patients with CUP is proposed with an emphasis on the role of transoral surgery