Noise-induced cochlear synaptopathy (CS) is defined as a permanent loss of synapses in the auditory nerve pathway following noise exposure. Several studies using auditory brainstem response (ABR) have indicated the presence of CS and increased central gain in tinnitus patients with normal hearing thresholds (TNHT), but the results were inconsistent. This meta-analysis aimed to review the evidence of CS and its pathological changes in the central auditory system in TNHT. Published studies using ABR to study TNHT were reviewed. PubMed, EMBASE, and Scopus databases were selected to search for relevant literature. Studies (489) were retrieved, and 11 were included for meta-analysis. The results supported significantly reduced wave I amplitude in TNHT, whereas the alternations in wave V amplitude were inconsistent among the studies. Consistently increased V/I ratio indicated noise-induced central gain enhancement. The results indicated the evidence of noise-induced cochlear synaptopathy in tinnitus patients with normal hearing. However, inconsistent changes in wave V amplitude may be explained by that the failure of central gain that triggers the pathological neural changes in the central auditory system and/or that increased central gain may be necessary to generate tinnitus but not to maintain tinnitus.
Background: Tinnitus is a disturbing symptom present in approximately 15% of the world population and between 2-7% of tinnitus sufferers seek medical help because of the chronic distress caused. Although well established that tinnitus can be present with and without hearing loss the different characteristics in terms of severity are still not completely known and studied. Aim: The objective of this study was to compare the severity of tinnitus in tinnitus patients with and without hearing loss. Materials and Methods: 73 tinnitus patients were included in this study at an audiology clinic in Amman, Jordan. Participants were assigned to two groups according to hearing status. The severity of tinnitus was evaluated using the Tinnitus Functional Index questionnaire. All participants were interviewed, followed by otoscopic examination, pure tone audiometry and tests for admittance and tinnitus matching. Results: The normal hearing group included 34 participants (46.6%) whose TFI scores were divided as follow: mild annoyance (17), significant annoyance ( 14) and severe annoyance (3). The sensorineural loss group included 39 participants (53.4%) with mild annoyance (11), significant annoyance (12) and severe annoyance (16). A statistically significant association was found between hearing status and the severity of tinnitus using a Chi Squared test (x 2 =0.487, p=0.007). There was no association between tinnitus severity and age or gender. Conclusion: Tinnitus severity was significantly worse in tinnitus patients with a hearing loss than tinnitus patients with normal hearing thresholds. This should be taken in consideration when clinicians are planning counselling and management protocols for individual patients.
Purpose Noise-induced hearing loss (NIHL) is a global issue that impacts people’s life and health. The current review aims to clarify the contributions and limitations of applying machine learning (ML) to predict NIHL by analyzing the performance of different ML techniques and the procedure of model construction. Methods The authors searched PubMed, EMBASE and Scopus on November 26, 2020. Results Eight studies were recruited in the current review following defined inclusion and exclusion criteria. Sample size in the selected studies ranged between 150 and 10,567. The most popular models were artificial neural networks (n = 4), random forests (n = 3) and support vector machines (n = 3). Features mostly correlated with NIHL and used in the models were: age (n = 6), duration of noise exposure (n = 5) and noise exposure level (n = 4). Five included studies used either split-sample validation (n = 3) or ten-fold cross-validation (n = 2). Assessment of accuracy ranged in value from 75.3% to 99% with a low prediction error/root-mean-square error in 3 studies. Only 2 studies measured discrimination risk using the receiver operating characteristic (ROC) curve and/or the area under ROC curve. Conclusion In spite of high accuracy and low prediction error of machine learning models, some improvement can be expected from larger sample sizes, multiple algorithm use, completed reports of model construction and the sufficient evaluation of calibration and discrimination risk.
Autoimmune diseases may cause various kinds of conflicts in and outside the target organ, and some evidence brings forward the suggestion that autoimmune diseases may damage the auditory nerve and cause sensorineural hearing loss. However, this relationship is not clearly defined yet. Therefore, the aim of this study was to assess sensorineural hearing loss in autoimmune diseases through systematic review and meta-analysis. The literature databases of PubMed, Google Scholar, Scopus, Web of knowledge, and Cochrane library were thoroughly searched, and a meta-analysis study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eighteen articles were included, involving 27 859 cases affected by autoimmune diseases. The prevalence of sensorineural hearing loss in systemic lupus erythematosus cases was 21.26 [3.80, 38.71]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 12.11 [7.4, 24.12] ( P < .001). The prevalence of sensorineural hearing loss in rheumatoid arthritis cases was 16.14 [−9.03, 41.31]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 2.23 [1.84, 2.32] ( P < .001). In vitiligo cases, the prevalence of sensorineural hearing loss was 38.80 [22.36, 55.25]%, which was significant, and pooled analysis of odds ratio observed in individual studies showed that the odds of sensorineural hearing loss prevalence was 5.82 [3.74, 9.68] ( P < .001). The present study showed that sensorineural hearing loss is significantly related to the autoimmune diseases of systemic lupus erythematosus, rheumatoid arthritis, and vitiligo. Therefore, these cases need a routine evaluation of sensorineural hearing loss. KEYWORDS : Hearing Loss, Sensorineural Hearing Loss (SNHL), Sudden Hearing Los, Autoimmune Diseases
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