Cochlear implantation with hearing preservation (HPCI) has allowed a cochlear implant (CI) electrode to be implanted while trying to preserve residual acoustic low-frequency hearing. The concept arises from the importance of this low-frequency information and the limitations of a CI in several auditory domains. The combination of electrical hearing with either preserved acoustic hearing or amplified \'natural\' hearing has the potential to address these issues and enable children with HPCI to closely follow normal auditory development.The aim of this study is to evaluate the \'real-life\' benefit of preserved acoustic low-frequency hearing in children with a CI, understand the benefits of preserved natural hearing in complex listening situations and so enable parents and children to make an informed choice about implantation. Ultimately, helping to ensure the maximum number of children benefit from this life-changing intervention.
Nineteen ears in children and young people aged 6-17 years old with \'successful\' HPCI will be subjected to a test battery consisting of: (1) spatial release from masking; (2) complex pitch direction discrimination; (3) melodic identification; (4) perception of prosodic features in speech and (5) threshold equalising noise test. Subjects will be tested in the electro-acoustic stimulation (EAS)/electro-natural stimulation (ENS) and the electric-only (ES) condition, thereby acting as their own control group. Standard demographic and hearing health information will be collected. In the absence of comparable published data to power the study, sample size was determined on pragmatic grounds. Tests are exploratory and for hypothesis-generating purposes. Therefore, the standard criterion of p<0.05 will be used.
This study has been approved by the Health Research Authority and NHS Research Ethics Committee (REC) within the UK (22/EM/0017). Industry funding was secured via a competitive researcher-led grant application process. Trial results will be subject to publication according to the definition of the outcome presented in this protocol.

Far-advanced otosclerosis (FAO) refers to severe otosclerosis with scarce auditory functions. The identification of the best method to correctly listen to sound and speech has a large impact on patients\' quality of life. We retrospectively analyzed the auditory function of 15 patients affected by FAO who were treated with stapedectomy plus hearing aids independent of the severity of their auditory deficit before surgery. The combination of surgery and hearing aids allowed excellent recovery of the perception of pure tone sounds and speech. Four patients, because of poor auditory thresholds, needed a cochlear implant after stapedectomy. Despite being based on a small sample of patients, our results suggest that stapedotomy plus hearing aids could improve the auditory capacities of patients with FAO independent of their auditory thresholds at T0. The careful selection of patients is fundamental to obtain the best outcomes.

This study investigated the effect of sound therapy combined with drug therapy (SDT) on gap detection threshold and speech recognition scores in patients with sudden sensorineural hearing loss (SSNHL).
Patients with SSNHL were grouped randomly into SDT and drug therapy (DT) groups. All patients received standard drug treatment and patients in the SDT group additionally received sound stimulation for the affected ears for 6 days. Pure tone audiogram, speech recognition scores at normal and time-compressed rates under quiet and noisy conditions, and the gap detection threshold of the SDT and DT groups before treatment and on day 6 and 30 after treatment were compared.
There were 20 patients in the SDT group and 24 in the DT group. The pure tone thresholds of affected ears were significantly lower in the SDT group on day 6 after treatment than those in the DT group at 125 and 250 Hz. Significantly lower gap detection thresholds and higher speech recognition scores under noisy conditions were observed at the normal and time-compressed rates in the SDT group than those in the DT group on day 6 and 30 after treatment. Significant correlations were observed between the gap thresholds and speech recognition scores in a noisy environment at normal and time-compressed rates on day 6 and 30.
SDT may improve the recovery of hearing abilities, such as the gap in noise thresholds and speech recognition in noise, in the case of SSNHL.
ChiCTR-IOR-17012262.

BACKGROUND: Vitiligo is characterized by the destruction of functional melanocytes in the skin. This destruction can target melanocytes anywhere in the body, in turn affecting the function of the organs in which the affected melanocytes reside. Melanocytes in the skin, uveal tract and ear are similar in their physiology and morphology, and share a common embryological origin.
OBJECTIVE: To study the association of vitiligo with ocular and auditory abnormalities.
METHODS: This case-control study was carried out on 40 patients with vitiligo and 20 healthy controls (HCs). All patients and HCs underwent auditory examination (otoscopic examination and immittance audiometry to assess middle ear pressure and exclude tympanic membrane perforation; pure tone audiometry to assess peripheral hearing sensitivity; and transient evoked otoacoustic emissions to assess central hearing ability) and standard ocular examination including visual acuity test, slit lamp biomicroscopy and optical coherence tomography.
RESULTS: Compared with controls, there was a significantly higher prevalence of hearing loss and ocular abnormalities in patients with vitiligo but no significant difference in visual acuity.
CONCLUSIONS: Vitiligo is a systemic disease that can be associated with impairment of melanocyte function organs other than the skin, including the eyes and ears. The function of auditory melanocytes is related to the hearing process and thus their destruction could lead to hearing impairment. By contrast, ocular melanocytes do not play a direct role in detection or transfer of visual information, and thus should not affect vision. Vitiligo may be associated with ocular abnormalities and hearing loss.

UNASSIGNED: As tympanotomy using the transcanal approach was a routine surgical technique for traumatic ossicular disruption, the efficacy of the posterior tympanum approach was rarely explored.
UNASSIGNED: This study aimed to investigate whether the hearing outcomes improved after simultaneous ossiculoplasty and facial nerve decompression using the posterior tympanum approach compared with the transcanal approach.
UNASSIGNED: The data of 11 patients who underwent ossiculoplasty and facial nerve decompression using the posterior tympanum approach and 21 patients who underwent ossiculoplasty via transcannal approach were analyzed.
UNASSIGNED: The average air-bone gap (ABG) of patients undergoing posterior tympanotomy showed a statistically significant improvement. Postoperative ABG within 20 dB was observed in 81.8% of patients in the posterior tympanum group and 76.2% of patients in the transcanal group. However, the ABG closure in the two groups was not statistically different.
UNASSIGNED: Simultaneous ossiculoplasty using the posterior tympanum approach was practical, and the hearing outcomes were promising for the patients with traumatic facial nerve paralysis and ossicular disruption.

OBJECTIVE: Evaluation of 3D Dyna-CTs to improve cochlear implantation (CI) planning and intraoperative electrically elicited stapedius reflex threshold (ESRT) measurements.
METHODS: A prospective observational cohort study was performed. Anonymized data collection of Dyna-CTs and CI surgeries in which a retrofacial approach was implemented to access the stapedius muscle. 3D Dyna-CTs of 30 patients and the intraoperative confirmation of the predication in 5/30 patients during CI surgery were evaluated. Inter-rater reliability was also analyzed along with the predictive value of this evaluation.
RESULTS: 36 representative structures of the middle and inner ear and 3D renderings of the Dyna-CTs were evaluated by four otoneurological surgeons. Fleiss\' kappa values for the evaluation of the visibility were high (> 0.7) for most of the anatomical structures. The stapedius muscle was visible in 90% of the cases. Using the 3D data, the retrofacial access to the stapedius muscles was estimated as feasible in 86.7%. Fleiss\' kappa value of the evaluation of the accessibility was 0.942. The intraoperative exploration of the stapedius muscle confirmed the preoperative prediction in all five selected patients (four patients with predicted accessibility and one patient with predicted inaccessibility).
CONCLUSIONS: The use of Dyna-CT and 3D rendering is a helpful tool for preoperative planning of cochlear implantations and ESRT measurements from the stapedius muscle via the retrofacial approach.

Objective: To assess whether CI programming by means of a software application using artificial intelligence (AI), FOX®, may improve cochlear implant (CI) performance. Patients: Two adult CI recipients who had mixed auditory results with their manual fitting were selected for an AI-assisted fitting. Even after 17 months CI experience and 19 manual fitting sessions, the first subject hadn\'t developed open set word recognition. The second subject, after 9 months of manual fitting, had developed good open set word recognition, but his scores remained poor at soft and loud presentation levels. Main outcome measure(s): Cochlear implant fitting parameters, pure tone thresholds, bisyllabic word recognition, phonemic discrimination scores and loudness scaling curves. Results: For subject 1, a first approach trying to optimize the home maps by means of AI-proposed adaptations was not successful whereas a second approach based on the use of Automaps (an AI approach based on universal, i.e. population based group statistics) during 3 months allowed the development of open set word recognition. For subject 2, the word recognition scores improved at soft and loud intensities with the AI suggestions. The AI-suggested modifications seem to be atypical. Conclusions: The two case studies illustrate that adults implanted with manual CI fitting may experience an improvement in their auditory results with AI-assisted fitting.

Traditional hearing conservation programs are based on the premise that noise dose, as measured by the time-weighted average noise level, is the primary risk factor associated with occupational hearing loss and that permanent threshold shifts are the most relevant outcome measures for determining when a noise-related hearing loss has occurred. However, recent studies in animal models have suggested that significant neurological damage to the hearing system can occur from noise exposures even when they are not severe enough to result in permanent threshold shifts. This has led to a number of studies attempting to relate subjective measures of noise exposure to subjective measures of hearing difficulty and suprathreshold measures of hearing performance (e.g., speech-in-noise tests). In this study, 3,330 U.S. service members volunteered to complete a survey on noise exposure, subjective hearing complaints, and tinnitus in conjunction with their annual hearing tests. Two questions were also included about the frequency and duration of temporary hearing losses that may have been experienced by the service member. The results show that subjective reports of temporary threshold shifts were substantially more predictive of tinnitus and other hearing complaints than more traditional questions based on the frequency of noise exposure.

Bacterial meningitis may cause inner ear fibrosis and progressive cochlear ossification with irreversible profound hearing loss (HL). Recognition of potential ossification is essential for effective management. We present a clinical case of a 4 year old boy who developed a progressive HL starting 3 weeks after meningitis. For the prospective risk of cochlear ossification, bilateral cochlear implantation (CI) was performed. Unexpectedly, unaided hearing threshold began to show improvement on the left ear, starting 4 months after meningitis and continuing for years post CI surgery. In order to explore the residual cochlear function, a trial of exclusively acoustic amplification was performed on the improved left side 5 years post implantation, providing good results. A certain degree of hearing recovery may be expected after meningitis related deafness. This case encourages surgeons to always adopt atraumatic surgical techniques that can enable the preservation of cochlear structure and residual function after CI surgery.

BACKGROUND: The aim of this article is to assess the impacts of low frequency noise, emitted by high-voltage lines and power poles, on the perception of discomfort, comparing two different groups of inhabitants (exposed and unexposed groups) in two areas in the Northwest of Portugal. It proposes a new oriented methodology to assess discomfort due to the low frequency noise.
METHODS: Two predominantly urban areas were used to test the methodology: an \"exposed\" area with a high presence of the source under study and an \"unexposed\" area without records of power transmission lines. The research developed included measuring sound levels (in frequency bands from 10 to 160 Hz) with the help of a sound level meter in the two selected urban areas.
RESULTS: The real sound coming from the source was recorded and reproduced in an audiometric testing booth to determine the hearing threshold and discomfort of the volunteers. Using the criteria curve developed by DEFRA (Department for Environment, Food & Rural Affairs/University of Salford) in 2011, the results reveal that the sound levels recorded for the \"exposed\" group were higher than that for the \"unexposed\" group. The first recording showed an average of 68.9 dB and the second 64.6 dB, resulting in a significant difference of 4.3 dB between the two groups. After an attempt to isolate the source, the difference was 5.6 dB. Regarding the adapted audiometric tests, the real sound was used, which was collected 5 m between the receiver and the source.
CONCLUSIONS: These results provide support that at this distance the noise was considered annoying.