Pure-tone threshold audiometry is currently the standard test of hearing. However, in everyday life, we are more concerned with listening to speech of moderate loudness and, specifically, listening to a particular talker against a background of other talkers. FreeHear delivers strings of three spoken digits (0–9, not 7) against a background babble via three loudspeakers placed in front and to either side of a listener. FreeHear is designed as a rapid, quantitative initial assessment of hearing using an adaptive algorithm. It is designed especially for children and for testing listeners who are using hearing devices. In this first report on FreeHear, we present developmental considerations and protocols and results of testing 100 children (4–13 years old) and 23 adults (18–30 years old). Two of the six 4 year olds and 91% of all older children completed full testing. Speech reception threshold (SRT) for digits and noise colocated at 0° or separated by 90° both improved linearly across 4 to 12 years old by 6 to 7 dB, with a further 2 dB improvement for the adults. These data suggested full maturation at approximately 15 years old SRTs at 90° digits/noise separation were better by approximately 6 dB than SRTs colocated at 0°. This spatial release from masking did not change significantly across age. Test–retest reliability was similar for children and adults (standard deviation of 2.05–2.91 dB SRT), with a mean practice improvement of 0.04–0.98 dB. FreeHear shows promise as a clinical test for both children and adults. Further trials in people with hearing impairment are ongoing.
A rapid review of audio-vestibular symptoms relating to SARS-CoV-2 and COVID-19 appeared in IJA in 2020 (Almufarrij, Uus, and Munro 2020), but the first systematic review and meta-analysis appeared in 2021 (Almufarrij and Munro 2021). Their pooled prevalence estimates of hearing loss, tinnitus and rotatory vertigo, based primarily on retrospective recall of symptoms, were 7.6% (CI: 2.5-15.1), 14.8% (CI: 6.3-26.1) and 7.2% (CI: 0.01-26.4), respectively. Almufarrij and Munro urged caution when interpreting these data because it was not always clear within each study if the symptom associated with SARS-CoV-2 and COVID-19 was new or a change (i.e. the prevalence may have been over-estimated if the symptoms were present before, and unchanged by, . With this in mind, we reviewed the 28 studies in their metaanalysis and attempted to contact authors of individual studies
Objectives:The threshold equalizing noise (TEN(HL)) is a clinically administered test to detect cochlear "dead regions" (i.e., regions of loss of inner hair cell [IHC] connectivity), using a "pass/fail" criterion based on the degree of elevation of a masked threshold in a tonedetection task. With sensorineural hearing loss, some elevation of the masked threshold is commonly observed but usually insufficient to create a "fail" diagnosis. The experiment reported here investigated whether the gray area between pass and fail contained information that correlated with factors such as age or cumulative high-level noise exposure (>100 dBA sound pressure levels), possibly indicative of damage to cochlear structures other than the more commonly implicated outer hair cells.Design: One hundred and twelve participants (71 female) who underwent audiometric screening for a sensorineural hearing loss, classified as either normal or mild, were recruited. Their age range was 32 to 74 years. They were administered the TEN test at four frequencies, 0.75, 1, 3, and 4 kHz, and at two sensation levels, 12 and 24 dB above their puretone absolute threshold at each frequency. The test frequencies were chosen to lie either distinctly away from, or within, the 2 to 6 kHz region where noise-induced hearing loss is first clinically observed as a notch in the audiogram. Cumulative noise exposure was assessed by the Noise Exposure Structured Interview (NESI). Elements of the NESI also permitted participant stratification by music experience.Results: Across all frequencies and testing levels, a strong positive correlation was observed between elevation of TEN threshold and absolute threshold. These correlations were little-changed even after noise exposure and music experience were factored out. The correlations were observed even within the range of "normal" hearing (absolute thresholds ≤15 dB HL).Conclusions: Using a clinical test, sensorineural hearing deficits were observable even within the range of clinically "normal" hearing. Results from the TEN test residing between "pass" and "fail" are dominated by processes not related to IHCs. The TEN test for IHCrelated function should therefore only be considered for its originally designed function, to generate a binary decision, either pass or fail.
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