Objective: To investigate the clinical effects of single-stage auricular reconstruction and hearing rehabilitation in children with microtia and external auditory canal atresia. Methods: Sixty eight cases of microtia with external auditory canal atresia (53 males and 15 females, age from 7 to 12 years, with a median age of 8.8 years), who received operations in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine from July 2017 to December 2019 were collected.A total of 28 cases received auricle reconstruction with high-density polyethylene (Medpor) framework and hearing reconstructions, among which 20 patients received the traditional external auditory canal and middle ear repair (EACR), and eight patients were implanted bone conduction device bone bridge(BB) simultaneously.In the control group, 40 patients only received Medpor frame implantation for auricle plasty. Postoperative changes in auricle morphology and auditory function and postoperative complications were evaluated. Results: After three to thirty months follow-ups, the auricles shape recovered well in all three groups. The average scores of 14 fine structures in the auricles were 9.43(EACR) and 10.67(BB) points. The average score of auricle symmetry were 6.83(EACR) and 6.00(BB) points. There was no significant difference compared to the auricle reconstruction group (8.23/6.20 points). P>0.05. After surgery, the average hearing improvement in the BB group was 43.33 dB HL and the average speech recognition threshold declined 42.28 dB HL. In the EACR group, the average hearing improvement was 4.13 dB HL and the average speech recognition threshold declined 11.36 dB HL. No vertigo, tinnitus, cerebrospinal fluid leakage and other complications occurred in all the patients. In the EACR group, sensorial hearing loss, auricle stent fracture, ear canal restenosis and ear canal atresia occurred in one patient respectively. In the auricle group, one auricle stent exposure and one facial branch nerve injury occurred. Nearly ten patients had difficulty in hair growth at scalp incisions. Conclusions: The operation of single-stage auricular reconstruction and hearing rehabilitation for microtia is feasible. The methods of hearing reconstruction should be determined by evaluating the development of the inner and middle ear of the patients. For those with poor mastoid development, bone bridge implantation is recommended to achieve a stable and significant hearing effect.
Child ; China ; Congenital Microtia/surgery* ; Female ; Hearing ; Hearing Loss/rehabilitation* ; Humans ; Male ; Polyethylenes ; Reconstructive Surgical Procedures

BACKGROUND AND OBJECTIVES: Hearing loss is a common complication associated with Noonan syndrome (NS), and the level of hearing loss for NS patients with sensorineural loss ranged from normal to severe. Additional insights into the outcome of cochlear implantation (CI)in children with NS with or without comorbidities are needed. SUBJECTS AND METHOD: In this study, five patients with NS, four with a mutation in PTPN11 and one who tested negative in mutation screening, diagnosed with the clinical scoring systemand underwent CI at ages ranging from 16 to 50 months were retrospectively reviewed. Patientswere evaluated for auditory perception (Categories of Auditory Performance), speech production (Korean Version of the Ling's Stage), and language ability (Receptive and Expressive Vocabulary Test). RESULTS: In five of the children with NS, CI was performed without any complications. Threepatients who received CI before 30 months of age showed outstanding outcomes. One patientwho received CI at 50 months showed limited benefit. One patient who was diagnosed with developmental delay and cochlear nerve hypoplasia underwent CI at 28 months with poor outcome. DISCUSSION: Our report suggests that although the benefit may be influenced by comorbidities associated with NS or delay in hearing rehabilitation, profound hearing loss in patientswith NS may be restored to normal levels in terms of auditory/speech perception and vocabulary/language development. The variable hearing outcomes also underscore the need for earlyscreening and detection of profound hearing loss, and regular follow-up for hearing evaluationin patients with NS.
Auditory Perception ; Child ; Cochlear Implantation ; Cochlear Implants ; Cochlear Nerve ; Comorbidity ; Follow-Up Studies ; Hearing ; Hearing Loss ; Humans ; Language ; Mass Screening ; Methods ; Noonan Syndrome ; Rehabilitation ; Retrospective Studies ; Vocabulary

Hearing loss is very common and economically burdensome. No accepted therapeutic modality for sensorineural hearing loss is yet available; most clinicians emphasize rehabilitation, placing hearing aids and cochlear implants. Photobiomodulation (PBM) employs light energy to enhance or modulate the activities of specific organs, and is a popular non-invasive therapy used to treat skin lesions and neurodegenerative disorders. Efforts to use PBM to improve hearing have been ongoing for several decades. Initial in vitro studies using cell lines and ex vivo culture techniques have now been supplanted by in vivo studies in animals; PBM protects the sensory epithelium and triggers neural regeneration. Many reports have used PBM to treat tinnitus. In this brief review, we introduce PBM applications in hearing research, helpful protocols, and relevant background literature.
Animals ; Cell Line ; Cochlear Implants ; Culture Techniques ; Epithelium ; Hearing Aids ; Hearing Loss ; Hearing Loss, Sensorineural ; Hearing ; In Vitro Techniques ; Low-Level Light Therapy ; Neurodegenerative Diseases ; Regeneration ; Rehabilitation ; Skin ; Tinnitus

BACKGROUND AND OBJECTIVES: The present study probed into the relative and combined contribution of auditory and visual modalities in the speech perception of individuals with auditory neuropathy spectrum disorders (ANSD). Specifically, the identification scores of consonant-vowel (CV) syllables, visual enhancement (VE), and auditory enhancement in different signal to noise ratios (SNRs) were compared with that of the control group. SUBJECTS AND METHODS: The study used a repeated measure standard group comparison research design. Two groups of individuals in the age range of 16 to 35 years participated in the study. The clinical group included 35 participants diagnosed as ANSD, while the control group had 35 age and gender matched individuals with typical auditory abilities. The participants were assessed for CV syllable identification in auditory only (A), visual only (V), and auditory-visual (AV) modalities. The syllables were presented in quiet and at 0 dB SNR. RESULTS: The speech identification score was maximum in AV condition followed by A-condition and least in V condition. This was true in both the groups. The individuals with ANSD were able to make better use of visual cues than the control group, as evident in the VE score. CONCLUSIONS: The dynamics of speech perception in the AV mode is different between ANSD and control. There is definite benefit of auditory as well as visual cues to individuals with ANSD, suggesting the need to facilitate both the modalities as part of the audiological rehabilitation. Future studies can focus on independently facilitating the two modalities and testing the benefits in the AV mode of speech perception in individuals with ANSD.
Cues ; Hearing Loss ; Noise ; Rehabilitation ; Research Design ; Signal-To-Noise Ratio ; Speech Perception

OBJECTIVES: The aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea. METHODS: This study analyzed data from the Ministry of Health and Welfare's project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015). RESULTS: The referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan. CONCLUSIONS: Hearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.
Child ; Cochlear Implants ; Correction of Hearing Impairment ; Daegu ; Gyeongsangbuk-do ; Hearing Aids ; Hearing Loss ; Hearing Tests ; Hearing* ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Korea* ; Lost to Follow-Up ; Mass Screening* ; Parturition ; Referral and Consultation ; Rehabilitation ; Risk Factors ; Ulsan

OBJECTIVES: Two main digital signal processing technologies inside the modern hearing aid to provide the best conditions for hearing aid users are directionality (DIR) and digital noise reduction (DNR) algorithms. There are various possible settings for these algorithms. The present study evaluates the effects of various DIR and DNR conditions (both separately and in combination) on listening comfort among hearing aid users. METHODS: In 18 participants who received hearing aid fitting services from the Rehabilitation School of Shahid Beheshti University of Medical Sciences regularly, we applied acceptable noise level (ANL) as our subjective measure of listening comfort. We evaluated both of these under six different hearing aid conditions: omnidirectional-baseline, omnidirectional-broadband DNR, omnidirectional-multichannel DNR, directional, directional-broadband DNR, and directional-multichannel DNR. RESULTS: The ANL results ranged from −3 dB to 14 dB in all conditions. The results show, among all conditions, both the omnidirectional-baseline condition and the omnidirectional-broadband DNR condition are the worst conditions for listening in noise. The DIR always reduces the amount of noise that patients received during testing. The DNR algorithm does not improve listening in noise significantly when compared with the DIR algorithms. Although both DNR and DIR algorithms yielded a lower ANL, the DIR algorithm was more effective than the DNR. CONCLUSION: The DIR and DNR technologies provide listening comfort in the presence of noise. Thus, user benefit depends on how the digital signal processing settings inside the hearing aid are adjusted.
Hearing Aids* ; Hearing Loss ; Hearing* ; Humans ; Noise* ; Rehabilitation ; Signal Processing, Computer-Assisted

It is challenging to achieve sufficient hearing gain in patients with mixed hearing loss. In chronic middle ear diseases, conventional passive reconstructive surgeries often result in suboptimal hearing gain and additional hearing aids may have limitations due to insufficient sound amplification, occlusion effect, acoustic feedback, and skin irritation. Middle ear implantation (MEI) using Vibrant Soundbridge (VSB) is another option for auditory rehabilitation in mixed hearing loss as well as sensorineural hearing loss. The floating mass transducer of VSB can be placed on various middle ear structures either directly or using different types of couplers in order to deliver vibratory mechanical energy to the cochlea. We report a patient who presented with bilateral mixed hearing loss due to chronic otitis media and had limitations using conventional hearing aids in the worse hearing ear. The patient was successfully treated with MEI using the Bell coupler together with middle ear surgery in a single step.
Acoustics ; Cochlea ; Ear ; Ear, Middle* ; Hearing ; Hearing Aids ; Hearing Loss, Mixed Conductive-Sensorineural* ; Hearing Loss, Sensorineural ; Humans ; Ossicular Prosthesis* ; Otitis Media ; Rehabilitation ; Skin ; Transducers

OBJECTIVES: The aim of this study was to analyze the current status and problems of hearing screening tests for newborns in low-income families in the southeastern Korea.METHODS: This study analyzed data from the Ministry of Health and Welfare's project on the early detection of hearing loss in newborns in low-income families in the southeastern Korea (2011-2015).RESULTS: The referral rate was 1.33, 1.69, and 1.27% in Daegu, Gyeongbuk, and Ulsan, respectively. The confirmatory test rate was 36.09, 23.38, and 52.94% in Daegu, Gyeongbuk, and Ulsan, respectively. The incidence of hearing loss (adjusted) was 0.41, 0.62, and 0.41% in Daegu, Gyeongbuk, and Ulsan, respectively. After confirming hearing loss, newborns with hearing handicaps were mostly lost to follow-up, and rehabilitation methods, such as hearing aids or cochlear implants, were not used. The screening tests were performed within 1 month of birth, and the confirmatory tests were generally performed within 3 months of birth. However, more than 3 months passed before the confirmatory tests were performed in infants with risk factors for hearing loss in Gyeongbuk and Ulsan.CONCLUSIONS: Hearing screening tests were conducted in newborns from low-income families in southeastern Korea who received a coupon for free testing, but the newborns that were referred after the screening tests were not promptly linked to the hospitals where confirmatory tests were performed. Furthermore, hearing rehabilitation was not consistently performed after hearing loss was confirmed. To successful early hearing loss detection and intervention, a systematic tracking system of hearing loss children is needed.
Child ; Cochlear Implants ; Correction of Hearing Impairment ; Daegu ; Gyeongsangbuk-do ; Hearing Aids ; Hearing Loss ; Hearing Tests ; Hearing ; Humans ; Incidence ; Infant ; Infant, Newborn ; Korea ; Lost to Follow-Up ; Mass Screening ; Parturition ; Referral and Consultation ; Rehabilitation ; Risk Factors ; Ulsan

OBJECTIVES: We investigated the normative data on the hearing threshold levels of Koreans with normal tympanic membranes and the prevalence of hearing loss (HL) and nonserviceable hearing using the data from the Korea National Health and Nutrition Examination Surveys (KNHANES) during 2010–2012. METHODS: Data obtained from 16,673 participants ≥12-year-of-age with normal tympanic membranes who completed audiometric testing. We defined HL as the pure tone average (PTA) >25 dB hearing level at 500, 1,000, 2,000, and 3,000 Hz and non-serviceable hearing as PTA >40 dB hearing level. RESULTS: The hearing levels at some frequencies (0.5, 3, and 6 kHz) did not differ in between the 10's and 20's, but the hearing thresholds at all frequencies increased gradually from the 30's. The hearing thresholds were higher in men than in women at high frequencies (3, 4, and 6 kHz) in the 30's and older. The prevalence of HL in either ear was 16.5% (estimates of 5.9 million), from 2.4% in the 10's up to 75.4% in the 70's and older. The prevalence of nonserviceable hearing in either ear was 6.8% (estimates of 2.5 million) and that of bilateral nonserviceable hearing was 2.5% (estimates of 0.9 million). CONCLUSION: Hearing loss aggravated from the 30's at all frequencies and men showed poorer hearing levels than women at high frequencies. Hearing loss was a common condition and the prevalence of non-serviceable hearing in either ear, which needs hearing rehabilitation to help social communication, was 6.8%. Normative pure tone thresholds at each frequency can be used as referent values when counseling patients complaining of hearing loss.
Audiometry ; Counseling ; Ear ; Female ; Hearing Loss* ; Hearing* ; Humans ; Korea ; Male ; Prevalence* ; Rehabilitation ; Tympanic Membrane*

The aim of present study is to evaluate and compare speech intelligibility in hearing impaired children with cochlear implants (CI) and hearing aid (HA) users and children with normal hearing (NH). The sample consisted of 45 Persian-speaking children aged 3 to 5-years-old. They were divided into three groups, and each group had 15, children, children with CI and children using hearing aids in Hamadan. Participants was evaluated by the test of speech intelligibility level. Results of ANOVA on speech intelligibility test showed that NH children had significantly better reading performance than hearing impaired children with CI and HA. Post-hoc analysis, using Scheffe test, indicated that the mean score of speech intelligibility of normal children was higher than the HA and CI groups; but the difference was not significant between mean of speech intelligibility in children with hearing loss that use cochlear implant and those using HA. It is clear that even with remarkabkle advances in HA technology, many hearing impaired children continue to find speech production a challenging problem. Given that speech intelligibility is a key element in proper communication and social interaction, consequently, educational and rehabilitation programs are essential to improve speech intelligibility of children with hearing loss.
Child* ; Cochlear Implants* ; Hearing Aids* ; Hearing Loss ; Hearing* ; Humans ; Interpersonal Relations ; Rehabilitation ; Speech Intelligibility*