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  1. Zakaria MN, Jalaei B, Wahab NA
    Eur Arch Otorhinolaryngol, 2016 Feb;273(2):349-54.
    PMID: 25682179 DOI: 10.1007/s00405-015-3555-3
    For estimating behavioral hearing thresholds, auditory steady state response (ASSR) can be reliably evoked by stimuli at low and high modulation frequencies (MFs). In this regard, little is known regarding ASSR thresholds evoked by stimuli at different MFs in female and male participants. In fact, recent data suggest that 40-Hz ASSR is influenced by estrogen level in females. Hence, the aim of the present study was to determine the effect of gender and MF on ASSR thresholds in young adults. Twenty-eight normally hearing participants (14 males and 14 females) were enrolled in this study. For each subject, ASSR thresholds were recorded with narrow-band chirps at 500, 1,000, 2,000, and 4,000 Hz carrier frequencies (CFs) and at 40 and 90 Hz MFs. Two-way mixed ANOVA (with gender and MF as the factors) revealed no significant interaction effect between factors at all CFs (p > 0.05). The gender effect was only significant at 500 Hz CF (p < 0.05). At 500 and 1,000 Hz CFs, mean ASSR thresholds were significantly lower at 40 Hz MF than at 90 Hz MF (p < 0.05). Interestingly, at 2,000 and 4,000 Hz CFs, mean ASSR thresholds were significantly lower at 90 Hz MF than at 40 Hz MF (p < 0.05). The lower ASSR thresholds in females might be due to hormonal influence. When recording ASSR thresholds at low MF, we suggest the use of gender-specific normative data so that more valid comparisons can be made, particularly at 500 Hz CF.
    Matched MeSH terms: Auditory Threshold/physiology*
  2. Subha ST, Raman R
    Ear Nose Throat J, 2006 Oct;85(10):650, 652-3.
    PMID: 17124935
    We performed a study to determine if cerumen in the ear canal causes significant hearing loss and to ascertain if there is any correlation between the amount of cerumen and the degree of hearing loss. Our study was conducted on 109 ears in 80 patients. The results indicated that impacted cerumen does cause a significant degree of conductive hearing loss. We found no significant correlation between the length of the cerumen plug and the severity of hearing loss. Nor did we find any significant correlation between the presence of impacted cerumen and variables such as age, sex, ethnicity, or affected side.
    Matched MeSH terms: Auditory Threshold/physiology*
  3. Jalaei B, Shaabani M, Zakaria MN
    Braz J Otorhinolaryngol, 2017 Jan-Feb;83(1):10-15.
    PMID: 27102175 DOI: 10.1016/j.bjorl.2015.12.005
    INTRODUCTION: The performance of auditory steady state response (ASSR) in threshold testing when recorded ipsilaterally and contralaterally, as well as at low and high modulation frequencies (MFs), has not been systematically studied.

    OBJECTIVE: To verify the influences of mode of recording (ipsilateral vs. contralateral) and modulation frequency (40Hz vs. 90Hz) on ASSR thresholds.

    METHODS: Fifteen female and 14 male subjects (aged 18-30 years) with normal hearing bilaterally were studied. Narrow-band CE-chirp(®) stimuli (centerd at 500, 1000, 2000, and 4000Hz) modulated at 40 and 90Hz MFs were presented to the participants' right ear. The ASSR thresholds were then recorded at each test frequency in both ipsilateral and contralateral channels.

    RESULTS: Due to pronounced interaction effects between mode of recording and MF (p<0.05 by two-way repeated measures ANOVA), mean ASSR thresholds were then compared among four conditions (ipsi-40Hz, ipsi-90Hz, contra-40Hz, and contra-90Hz) using one-way repeated measures ANOVA. At the 500 and 1000Hz test frequencies, contra-40Hz condition produced the lowest mean ASSR thresholds. In contrast, at high frequencies (2000 and 4000Hz), ipsi-90Hz condition revealed the lowest mean ASSR thresholds. At most test frequencies, contra-90Hz produced the highest mean ASSR thresholds.

    CONCLUSIONS: Based on the findings, the present study recommends two different protocols for an optimum threshold testing with ASSR, at least when testing young adults. This includes the use of contra-40Hz recording mode due to its promising performance in hearing threshold estimation.
    Matched MeSH terms: Auditory Threshold/physiology*
  4. Mukari SZMS, Yusof Y, Ishak WS, Maamor N, Chellapan K, Dzulkifli MA
    Braz J Otorhinolaryngol, 2018 12 10;86(2):149-156.
    PMID: 30558985 DOI: 10.1016/j.bjorl.2018.10.010
    INTRODUCTION: Hearing acuity, central auditory processing and cognition contribute to the speech recognition difficulty experienced by older adults. Therefore, quantifying the contribution of these factors on speech recognition problem is important in order to formulate a holistic and effective rehabilitation.

    OBJECTIVE: To examine the relative contributions of auditory functioning and cognition status to speech recognition in quiet and in noise.

    METHODS: We measured speech recognition in quiet and in composite noise using the Malay Hearing in noise test on 72 native Malay speakers (60-82 years) older adults with normal to mild hearing loss. Auditory function included pure tone audiogram, gaps-in-noise, and dichotic digit tests. Cognitive function was assessed using the Malay Montreal cognitive assessment.

    RESULTS: Linear regression analyses using backward elimination technique revealed that had the better ear four frequency average (0.5-4kHz) (4FA), high frequency average and Malay Montreal cognitive assessment attributed to speech perception in quiet (total r2=0.499). On the other hand, high frequency average, Malay Montreal cognitive assessment and dichotic digit tests contributed significantly to speech recognition in noise (total r2=0.307). Whereas the better ear high frequency average primarily measured the speech recognition in quiet, the speech recognition in noise was mainly measured by cognitive function.

    CONCLUSIONS: These findings highlight the fact that besides hearing sensitivity, cognition plays an important role in speech recognition ability among older adults, especially in noisy environments. Therefore, in addition to hearing aids, rehabilitation, which trains cognition, may have a role in improving speech recognition in noise ability of older adults.

    Matched MeSH terms: Auditory Threshold/physiology*
  5. Woei TJ, Mazlan R, Tamil AM, Rosli NSM, Hasbi SM, Hashim ND, et al.
    Int Tinnitus J, 2023 Dec 04;27(1):75-81.
    PMID: 38050889 DOI: 10.5935/0946-5448.20230013
    OBJECTIVE: The purpose of this study was to compare the reliability and accuracy of chirp-based Multiple Auditory Steady State Response (MSSR) and Auditory Brainstem Response (ABR) in children.

    METHODS: The prospective clinical study was conducted at Selayang Hospital (SH) and Hospital Canselor Tuanku Muhriz (HCTM) within one year. A total of 38 children ranging from 3 to 18 years old underwent hearing evaluation using ABR tests and MSSR under sedation. The duration of both tests were then compared.

    RESULTS: The estimated hearing threshold of frequency specific chirp MSSR showed good correlation with ABR especially in higher frequencies such as 2000 Hz and 4000Hz with the value of cronbach alpha of 0.890, 0.933, 0.970 and 0.969 on 500Hz, 1000Hz, 2000Hz and 4000Hz. The sensitivity of MSSR is 0.786, 0.75, 0.957 and 0.889 and specificity is 0.85, 0.882, 0.979 and 0.966 over 500Hz, 1000Hz, 2000Hz and 4000Hz. The duration of MSSR tests were shorter than ABR tests in normal hearing children with an average of 35.3 minutes for MSSR tests and 46.4 minutes for ABR tests. This can also be seen in children with hearing loss where the average duration for MSSR tests is 40.0 minutes and 52.0 minutes for ABR tests.

    CONCLUSION: MSSR showed good correlation and reliability in comparison with ABR especially on higher frequencies. Hence, MSSR is a good clinical test to diagnose children with hearing loss.

    Matched MeSH terms: Auditory Threshold/physiology
  6. Lim EY, Tang IP, Peyman M, Ramli N, Narayanan P, Rajagopalan R
    Eur Arch Otorhinolaryngol, 2015 Nov;272(11):3109-13.
    PMID: 25205300 DOI: 10.1007/s00405-014-3232-y
    High acoustic noise level is one of the unavoidable side effects of 3 T magnetic resonance imaging (MRI). A case of hearing loss after 3 T MRI has been reported in this institution and hence this study. The objective of this study was to determine whether temporary threshold shift (TTS) in high frequency hearing occurs in patients undergoing 3 T MRI scans of the head and neck. A total of 35 patients undergoing head and neck 3 T MRI for various clinical indications were tested with pure tone audiometry in different frequencies including high frequencies, before and after the MRI scan. Any threshold change from the recorded baseline of 10 dB was considered significant. All patients were fitted with foamed 3 M earplugs before the procedure following the safety guidelines for 3 T MRI. The mean time for MRI procedure was 1,672 s (range 1,040-2,810). The noise dose received by each patient amounted to an average of 3,906.29% (1,415-9,170%). The noise dose was derived from a normograph used by Occupational Noise Surveys. This was calculated using the nomograph of L eq, L EX, noise dose and time. There was no statistically significant difference between the hearing threshold before and after the MRI procedures for all the frequencies (paired t test, P > 0.05). For patients using 3 M foamed earplugs, noise level generated by 3 T MRI during routine clinical sequence did not cause any TTS in high frequency hearing.
    Matched MeSH terms: Auditory Threshold/physiology*
  7. Ishak WS, Zhao F, Rajenderkumar D, Arif M
    Int Tinnitus J, 2013;18(1):35-44.
    PMID: 24995898 DOI: 10.5935/0946-5448.20130006
    The general consensus on the roles of hearing loss in triggering tinnitus seems not applicable in patients with normal hearing thresholds. The absence of hearing loss on the audiogram in this group of patients poses a serious challenge to the cochlear theories in explaining tinnitus generation in this group of patients.
    Matched MeSH terms: Auditory Threshold/physiology*
  8. Tang IP, Prepageran N, Raman R, Sharizhal T
    J Laryngol Otol, 2009 Dec;123(12):1321-4.
    PMID: 19835642 DOI: 10.1017/S0022215109990806
    To determine whether epithelial migration in the atelectatic tympanic membrane (secondary to any pathology) occurs in a similar fashion to that in the normal (non-pathological) tympanic membrane, by calculating and comparing the epithelial migration rate and pattern.
    Matched MeSH terms: Auditory Threshold/physiology
  9. Dzulkarnain AAA, Abdullah SA, Ruzai MAM, Ibrahim SHMN, Anuar NFA, Rahim 'EA
    Am J Audiol, 2018 Sep 12;27(3):294-305.
    PMID: 30054628 DOI: 10.1044/2018_AJA-17-0087
    Purpose: The purpose of this study was to investigate the influence of 2 different electrode montages (ipsilateral and vertical) on the auditory brainstem response (ABR) findings elicited from narrow band (NB) level-specific (LS) CE-Chirp and tone-burst in subjects with normal hearing at several intensity levels and frequency combinations.

    Method: Quasi-experimental and repeated-measures study designs were used in this study. Twenty-six adults with normal hearing (17 females, 9 males) participated. ABRs were acquired from the study participants at 3 intensity levels (80, 60, and 40 dB nHL), 3 frequencies (500, 1000, and 2000 Hz), 2 electrode montages (ipsilateral and vertical), and 2 stimuli (NB LS CE-Chirp and tone-burst) using 2 stopping criteria (fixed averages at 4,000 sweeps and F test at multiple points = 3.1).

    Results: Wave V amplitudes were only 19%-26% larger for the vertical recordings than the ipsilateral recordings in both the ABRs obtained from the NB LS CE-Chirp and tone-burst stimuli. The mean differences in the F test at multiple points values and the residual noise levels between the ABRs obtained from the vertical and ipsilateral montages were statistically not significant. In addition, the ABR elicited from the NB LS CE-Chirp was significantly larger (up to 69%) than those from the tone-burst, except at the lower intensity level.

    Conclusion: Both the ipsilateral and vertical montages can be used to record ABR to the NB LS CE-Chirp because of the small enhancement in the wave V amplitude provided by the vertical montage.

    Matched MeSH terms: Auditory Threshold/physiology*
  10. Ami M, Abdullah A, Awang MA, Liyab B, Saim L
    Laryngoscope, 2008 Apr;118(4):712-7.
    PMID: 18176342 DOI: 10.1097/MLG.0b013e318161e521
    To investigate cochlear outer hair cell function based on distortion product otoacoustic emission (DPOAE) in patients with tinnitus.
    Matched MeSH terms: Auditory Threshold/physiology*
  11. Dewey RS, Francis ST, Guest H, Prendergast G, Millman RE, Plack CJ, et al.
    Neuroimage, 2020 Jan 01;204:116239.
    PMID: 31586673 DOI: 10.1016/j.neuroimage.2019.116239
    In animal models, exposure to high noise levels can cause permanent damage to hair-cell synapses (cochlear synaptopathy) for high-threshold auditory nerve fibers without affecting sensitivity to quiet sounds. This has been confirmed in several mammalian species, but the hypothesis that lifetime noise exposure affects auditory function in humans with normal audiometric thresholds remains unconfirmed and current evidence from human electrophysiology is contradictory. Here we report the auditory brainstem response (ABR), and both transient (stimulus onset and offset) and sustained functional magnetic resonance imaging (fMRI) responses throughout the human central auditory pathway across lifetime noise exposure. Healthy young individuals aged 25-40 years were recruited into high (n = 32) and low (n = 30) lifetime noise exposure groups, stratified for age, and balanced for audiometric threshold up to 16 kHz fMRI demonstrated robust broadband noise-related activity throughout the auditory pathway (cochlear nucleus, superior olivary complex, nucleus of the lateral lemniscus, inferior colliculus, medial geniculate body and auditory cortex). fMRI responses in the auditory pathway to broadband noise onset were significantly enhanced in the high noise exposure group relative to the low exposure group, differences in sustained fMRI responses did not reach significance, and no significant group differences were found in the click-evoked ABR. Exploratory analyses found no significant relationships between the neural responses and self-reported tinnitus or reduced sound-level tolerance (symptoms associated with synaptopathy). In summary, although a small effect, these fMRI results suggest that lifetime noise exposure may be associated with central hyperactivity in young adults with normal hearing thresholds.
    Matched MeSH terms: Auditory Threshold/physiology*
  12. Sayapathi BS, Su AT, Koh D
    J Occup Health, 2014;56(1):1-11.
    PMID: 24270928
    OBJECTIVES: A systematic review was conducted to identify the effectiveness of different permissible exposure limits in preserving the hearing threshold level. This review compared the limits of the US National Institute of Occupational Safety and Health with those of the US Occupational Safety and Health Administration. The prevalence of occupational noise-induced hearing loss is on an increasing trend globally. This review was performed to reduce the prevalence of noise-induced hearing loss.

    METHODS: We searched 3 major databases, i.e., PubMed, Embase and Lippincott Williams & Wilkins Journals@Ovid, for studies published up until 1May 2013 without language restrictions. All study designs were included in this review. The studies were identified and retrieved by two independent authors.

    RESULTS: Of 118 titles scanned, 14 duplicates were removed, and a total of 13 abstracts from all three databases were identified for full-text retrieval. From the full text, eight articles met the inclusion criteria for this systematic review. These articles showed acceptable quality based on our scoring system. Most of the studies indicated that temporary threshold shifts were much lower when subjects were exposed to a noise level of 85 dBA or lower.

    CONCLUSIONS: There were more threshold shifts in subjects adopting 90 dBA compared with 85 dBA. These temporary threshold shifts may progress to permanent shifts over time. Action curtailing noise exposure among employees would be taken earlier on adoption of 85 dBA as the permissible exposure limit, and hence prevalence of noise-induced hearing loss may be reduced.

    Matched MeSH terms: Auditory Threshold/physiology
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