How to cite this article: Vlastarakos PV, Plioutas J, Delidis A, et al. Introducing a modified algorithm for enhanced operator independency in auditory steady-state responses (AS-SRs) testing. Acta Otorhinolaryngol Ital 2021 Nov 26 [Online ahead of print].
Background and Objectives:To describe all possible facets of non-organic hearing disorders (NOHD) and emphasize the superiority of auditory steady-state response (ASSR) over previously employed hearing assessment tools. Subjects and Methods: A series of seven patients consisting of three males and four females with NOHD were assessed at Attikon University Hospital (age range: 17-59 years). Three patients had Munchausen syndrome, three intentionally feigned hearing loss, and one intentionally feigned normal hearing. The audiological evaluation consisted of tympanometry, pure-tone audiometry, and ASSR testing. Results:The hearing of all patients was accurately determined using ASSR. The results were confirmed by auditory brainstem responses (ABR) and otoacoustic emissions. Conclusions: NOHD is a multi-faceted condition encompassing various etiologies. ASSR testing represents an objective and reliable method of hearing assessment, which can serve as a gold standard method for distinguishing NOHD from actual hearing loss. It can reliably indicate the hearing levels at the four main frequencies (500, 1,000, 2,000, and 4,000 Hz) by obtaining a valid estimated audiogram through statistical measures. Compared to ABR testing, ASSR thresholds are closer to the actual audiometric thresholds in the presence of hearing impairment and are superior when the corresponding pure-tone audiogram is widely ranging between the adjacent frequencies or when the obtained ABR curves are not easily distinguished. A non-confrontational approach should be adopted by ENT doctors towards cases of suspected NOHD as the use of ASSR could reliably assess hearing even when medical or medico-legal implications are involved.
Background: Noise-induced hearing loss (NIHL) is a common occupational disease that both shipyard and battle cruiser workers may encounter, since they are both exposed to hazardous noise levels. However, both white-and blue-collar workers are simultaneously exposed to possible daily risk-factors of incident tinnitus and subsequent hearing loss (HL), such as caffeine and smoking. The aim of the present prospective study is to investigate the prevalence of HL in these working groups of the Greek Navy and the Hellenic Shipyard SA (HSY) in Skaramanga, Greece, and to look at the correlation between OHL and hazardous noise levels as well as other individual factors.Material and methods: During 2015-17, multiple choice questionnaires including questions referring to socio-demographic information, educational level, and daily habits were administered, and audiograms were performed, to 120 male white-and blue-collar workers, aged 23-30 years old. Statistical analysis was conducted using SPSS v.15.Results: HL in battle cruiser employees was correlated with occupational noise and individual factors such as caffeine, smoking, and educational level. Additionally, HL in shipyard employees was correlated with occupational noise, alcohol and caffeine intake, smoking, and educational level. A higher level of HL appeared to be correlated with higher levels of occupational noise, lower educational level, and larger consumption of caffeine, alcohol, and smoking. Dietary habits were non-significantly statistically correlated with HL in both types of workers.Conclusions: HL is a disease strongly related to the Navy and the shipyard industry. Therefore, constant monitoring of workers, implementation of hearing conservation programs, and using preventive measures are the cornerstone of preventing and treating HL. More research of HL in Navy employees should be conducted.
Introduction Early glottic cancer (EGC) is associated with a high cure rate. Hence, patients and physicians also focus on the impact of the proposed treatment on the speaking function of the preserved larynx. Objectives The present study assessed the impact of single-modality treatment (transoral laser microsurgery [TLM], or radiotherapy) or combination therapy for EGC on postinterventional voicing and explored factors which might explain the related perceptions. Methods A total of 108 patients filled in the voice handicap index 10 questionnaire, 1 and 2 years postinterventionally. Non-parametric tests were used for the respective statistical analyses. Results Sixty-four patients were treated with TLM, 15 with radiotherapy, and 29 with both modalities. Transoral microsurgery and radiotherapy were associated with postinterventional dysphonia, which attenuated between the first and second postintervention year (p = 0.000). No association between sociodemographic parameters and the attenuation of postinterventional dysphonia was identified for either treatment modality. Transoral microsurgery and radiotherapy resulted in comparable postinterventional voicing, in the first (p = 0.940) and second (p = 0.196) postintervention years. The addition of TLM to radiotherapy resulted in worse voice quality in the second, compared with the first postintervention year (p = 0.000), demonstrating a detrimental effect on speech intelligibility in noise (p = 0.000). Conclusion Single therapy should be favored over the combination of TLM and radiotherapy for EGC in terms of retaining better postinterventional voice quality. Postinterventional dysphonia should be taken into account, during preinterventional counseling, as it may exert leverage on the quality of patients' lives. Patients and physicians should acknowledge the optimal time of voice function return, which seems to be extending up to two years posttreatment.
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