We performed hearing screening using an automated brainstem response (ABR) system (MAICO: MB11, BERAphone®) in 134 children attending a health checkup program for 3-year-old children, and evaluated the efficacy of this screening method for hearing loss and the present status of hearing screening. The test duration required for a single ear was about 5-6 minutes, which was longer than that required for hearing screening of newborns. Examination of both ears could be accomplished in 120 (89.5%) of the 134 children, which suggests that this method can be adopted as a hearing screening test for 3-year-old children. The screening result was “pass” in 100 children, “unilateral refer” in 13, and “bilateral refer” in 7. Four children who visited medical institutions for “bilateral refer” showed otitis media in both ears. In the “whispered voice test,” in which ≤4 correct answers represents a “refer” result, the mean number of correct answers in children with a unilateral “refer” result was 5.4. Therefore, unilateral hearing loss is difficult to detect using the present hearing screening test. The accuracy of hearing screening is expected to improve with the use of the automated ABR test in 3-year-old children.
Seventeen years have passed since newborn hearing screening was first started in Akita prefecture, and the examination rate has exceeded 94% since 2012. While building a screening system, we firmly believe that collaboration to sustain the interest of related organizations in hearing impairment even beyond referrals from newborn hearing screening is necessary. In this study, we report diagnosing hearing impairment in some children who could not be identified by newborn hearing screening due to uncommon hearing types. This report is to emphasize that there are children with late-onset or progressive hearing impairment, and that it is therefore necessary to continue to strengthen cooperation with related organizations even after beyond referrals from newborn hearing screening. In this study, we confirmed that there are cases with incomplete diagnostic imaging, that cases with a genetic diagnosis may increase in the future, and that the number of confirmed cytomegalovirus infection follow-up cases is increasing. I conclude that there is a need to clarify the cause of delayed or progressive hearing loss in the future.
The purpose of this study was to investigate the effect of individual auditory training for hearing aid users. This study was performed in 139 patients (262 ears) who presented with sensorineural hearing disturbance and underwent training for adaptation to hearing aids and individual auditory training at our hospital for three months (auditory training group). As the control group, 89 patients (168 ears) who only underwent training for adaptation to hearing aids were included. The speech intelligibility score under the unaided condition was measured before and after the training in each group. Analysis using the Wilcoxon signed-rank test confirmed significant improvement of the speech intelligibility scores in both groups (p<0.001). However, there was no statistically significant improvement of the speech intelligibility score in the auditory training group as compared to the control group (Fisher's exact probability test, p=0.834). The results of the present investigation suggest that individual auditory training using the speech tracking method may not be particularly useful to improve the speech intelligibility score. Therefore, another analyzing method might be required to evaluate the utility of auditory training using speech tracking method.
We investigated an effective method for improving perception of the natural fast speech of wearers of cochlear implants (CIs) and hearing aids (HAs).
Our subjects comprised 17 subjects with CIs and 17 subjects with HAs. As experimental stimuli, we used sentence test materials of natural fast speech with ratios of 0.75 and 0.5 relative to normal-speed speech. The fast speech sentences were restored to 100% of the original duration by insertion of silent pauses at every syntactic boundary or at only one point syntactically in the passage.
Results showed greater improvement of the speech perception scores with insertion of a pause at only one point syntactically than with insertion of a pause at every syntactic boundary in natural fast speech with a 0.5 ratio. This tendency was also more pronounced in the CI users than in the HA users.
The results suggested that the effectiveness of insertion of pauses into natural fast speech is more effective when it is done at only one point syntactically, rather than at every syntactic boundary.
Objective: This study was aimed at evaluating the effect of sound therapy using a hearing aid with a sound generator (HA group) or sound delivered via a smartphone (SM group) for patients with bothersome tinnitus with high-frequency hearing loss (4KHz and/or 8KHz) and a score of >18 on the Tinnitus Handicap Inventory (THI).
Methods: A total of 23 patients with high-frequency sensorineural hearing loss were divided into the HA group (9 cases) and SM group (14 cases).
The treatment outcome was evaluated using the TH, subjective scores on tinnitus annoyance as evaluated by numerical scores for loudness, annoyance, effects on daily life, and severity. Each item was scored on a scale or 0 (representing no tinnitus) to 10 (worst tinnitus ever experienced). In addition, the self-rating grade index for improvement of tinnitus was also evaluated.
Results: Sound therapy with both the hearing aid with a sound generator and the smartphone application improved the THI scores, subjective tinnitus scores and self-rating grade index. There were no significant differences in the pre-and post-treatment scores on the THI or the evaluated items between the two groups. There were no significant differences in the self-rated improvement scores between the two groups. Hearing at the frequency of 4kHz was worse and the tinnitus duration before treatment was significantly longer in the HA group.
Conclusion: Long-term sound therapy delivered to the auditory apparatus, whether via a HA or smartphone application, is effective for alleviating tinnitus. Tinnitus patients with hearing loss at high frequencies (4, 8KHz) are advised to compare and select sound delivered via a smartphone application or a HA with a sound generator for sound therapy. On selecting, it is necessary to consider the hearing level of 4kHz, the duration of tinnitus before treatment and the cost of HA, and whether sound therapy is used during daytime work or at home after work.
A total of 273 infants visited Aichi Children's Health and Medical Center for further diagnostic evaluation after Newborn Hearing Screening (NHS) between April 2012 and March 2015. Of these, 262 infants in whom stable subjective hearing tests could be performed or who could be followed up for more than 2 years were included in this study. The average age at the first visit was 6.2 months, and the source of referral was the department of otolaryngology in 74.8% cases, gynecology in 12.2% cases and pediatrics in 10.2% cases. As a result, 137 (50.2%) children were identified as having bilateral moderate or severe hearing loss. In addition, otitis media with effusion (OME) was diagnosed in 88 infants (32.2%) at the first visit. Tympanostomy and/or tympanic ventilation tube insertion were performed in 78 of these infants (28.6%) before further diagnostic evaluation, with 21 (26.9%) showing improvement, as a result, to within mild hearing loss, suggesting the importance of exclusion of OME. On the other hand, treatment was postponed in 5 cases with multiple handicaps.
Objective tinnitus can be caused by myogenic diseases, vascular diseases, temporomandibular disorders, etc. We report a case of objective tinnitus which was related to arose from connection between the mandibular fossa and tympanic cavity. A 64-year-old female presented with tinnitus in the right ear at opening and closing of the mouth. At the same time, her tympanic membrane showed movement too, becoming retracted, as she opened her mouth. Sagittal-view computed tomographic (CT) images showed a low-density area in the temporomandibular joint, and a connection between the mandibular fossa and the tympanic cavity.
We assumed the following underlying mechanism for the tinnitus: 1) her weak petrotympanic fissure opened for some reason, which led to 2) negative pressure developing in the middle ear when she opened her mouth, which, in turn, led to 3) objective tinnitus. We performed a wide myringotomy.
With the release of the middle ear pressure by myringotomy, the air in the temporomandibular joint disappeared and her symptoms were relieved. Sagittal-view CT is helpful for the diagnosis of petrotympanic fissure, and myringotomy is effective for treatment.