Herein, the author briefly describes impedance audiometry, which includes tympanometry and evaluation of the acoustic reflex. Tympanometry is useful for the evaluation of pathological conditions of the tympanic membrane and middle ear. Tympanometry is applied routinely for the screening of hearing in neonates, along with evaluation of the auditory brainstem response (ABR). It has, however, recently been reported that tympanometry using 1000Hz as the probe tone in neonates younger than 3 months of age is easier to interpret and more reliable than 226-Hz tympanometry. Two methods to test the acoustic reflex (ipsi- and contralateral stimulation) can be used, and the test is still useful for evaluating the acoustic reflex pathway including the VIIth and VIIIth nerves in the brainstem in situations where the ABR and/or otoacoustic emission tests are not available.
We studied 50 patients with acute low-tone sensorineural hearing loss (ALHL) who were examined at Fukuoka University Hospital between January 2003 and March 2007. We used logistical regression analysis to determine the factors most strongly related to the outcome in patients with ALHL. The outcome of ALHL was cured (full recovery) in 36 patients, recovered (partial recovery) in 5 patients, and no change in 9 patients. The analysis was performed in the poor prognosis group (no change and partial recovery groups, 14 ears) and the full recovery group (36 ears). The following factors were examined as explanatory variables: age, sex, vestibular symptoms, number of days until presentation, therapy (steroids and diuretics), initial hearing levels at 125, 250, 500 and 1000Hz, and 1000-Hz distortion product otoacoustic emissions (DPOAE). Factors determined to be related to the outcome were the age, number of days until presentation, initial hearing levels at 125, 250, 500 and 1000Hz, and 1000-HzDPOAE. A long interval before the presentation and advanced age were associated with lower rates of cure (that is, of full recovery). Furthermore, profound initial hearing loss (125, 250, 500 and 1000Hz) was associated with lower rates of cure. A positive 1000-HzDPOAE level implied a better outcome. Previously, we had reported (61 ALHL patients) that the hearing outcome of ALHL was significantly better in female patients; however, in present study, the sex of the patient gender was not found to be a significant prognostic factor. This [?] is considered to be due to some type of social anxiety or stress in females.
Acute low-tone sensorineural hearing loss is defined as hearing impairment limited to low tones. However, several studies have suggested that a similar etiology exists among patients in whom the sum of the hearing levels at high-tone frequencies is 65dB or more. Herein, we classified such patients as probable cases and investigated the characteristics of the definite and probable cases that were treated at our hospital. As compared to the probable cases, the definite cases were younger and had a more favorable prognosis. Although the number of semi-definite cases may be expected to increase with the aging of society, a decreasing trend was observed.
In this study, cases of acute low-tone sensorineural hearing loss (ALHL) with difficulty in recovery were treated by psychological therapy. All suffered from hearing loss, tinnitus, and/or ear fullness for more than one month after the onset of the disease. It would be desirable for doctors to initiate psychological intervention from the very first visit of these patients to the ENT department. The doctors should judge the necessity and the indications for psychological therapy. Autonomous training and group therapy were found to serve as effective psychological therapy for these patients. Psychological tests are useful in screening for the necessity and indications of psychological therapy. If the results of psychological tests reveal a high grade of anxiety and/or depression, psychological treatment alone could not obtain good results for treatment of ALHL with difficulty in recovery.
Self-assessment of the hearing ability does not always correspond to that estimated by others. In this study, the differences between self- and family assessment of hearing were investigated in the hearing impaired seeking a hearing aid. A questionnaire survey to assess hearing in everyday life and evaluation of total hearing using a visual analog scale (VAS) method were employed. The results of both the questionnaire survey and VAS evaluation revealed that self-assessment of hearing was better than the family assessment. Significant differences were found for one-on-one conversation at a quiet place by both the questionnaire survey and VAS evaluation. When the subjects were classified according to age, self-assessment by VAS evaluation in the group of patients in their 50's alone was worse than that of the family's assessment. With regard to VAS evaluation, it was thought that the family's assessment might be more objective than self-assessment. On the other hand, in regard to conversation over the telephone, our results showed that the reliability of self assessment was superior to that of the family's assessment.
We followed and investigated the problems of fitting of hearing aids for aged people and of the fitting system used, and also the role of speech therapists by investigating the cases encountered by us over the last five years at the extraneous? department of hearing aids of our clinic. The results were as follows; 1. The age of the subjects and hearing ability did not significantly influence the rate of wearing hearing aids, while the number of fittings and whether or not the subjects having family significantly affected it. We found that in the cases of the times of fitting over in which the number of fitting sessions? was over 6, the rate of wearing hearing aids touched 100%. We found that aged people prefer to wear an in-the-canal-type hearing aid for a lateral ear than the lateral ear type of hearing aid. 2. It was necessary to counsel the patients and politely handle each trouble wearing hearing aids. The results of the analysis suggested that having raise up the degree of satisfaction of them with wearing hearing aids, also raised up the rate of wearing hearing aids for them the rate of wearing hearing aids increased as the degree of satisfaction with the hearing increased. 3. It is especially important to establish a network and a cooperative fitting system for hearing aids involving otolaryngologists, speech therapists and the shops dealing with the hearing aids. Such a system may be expected to promote the effective use of hearing aids.
We studied 78 elderly adults using hearing aids, seen at our clinic for Hearing aid dispensation between October 2003 and May 2007. The mean±SD age of the subjects was 74.0±8.3 years. Of the 78 subjects, 69 had a hearing on the better side of within 60dB, and 55 of these 69 subjects had better […than…?] speech recognition scores. Thus, the majority of these patients could use hearing aids effectively. Elderly adults are afraid of hearing impairment and hate hearing aids, because hearing loss is represents a sign of aging. They hold the myth that only people with severe or profound hearing loss use hearing aids and that hearing aids function poorly??. With the objective of impoving the image of hearing aids, we designed hearing aids with earrings able to change that can be changed like earrings??. We must emphasize to the elderly that they can maintain their mental health and acuity of active communication by seeking early hearing tests and early use of hearing aids.