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ObjectivesHearing loss (HL) affects 20% of the world’s population, with shortages of audiologists and audiometric sound booths unable to meet demand for hearing care services. We aimed to assess the accuracy of tablet-based audiometry (TA) to screen for HL at standard (0.25–8 kHz) and extended high frequencies (>8 kHz).DesignDiagnostic accuracy study.SettingTwo secondary care audiology and ear, nose and throat outpatient clinics in the UK between April 2022 and September 2023.ParticipantsAdults aged≥16 years undergoing sound booth audiometry (SBA).InterventionsTA, hearing-related questionnaires and patient usability questionnaires.Outcome measuresSensitivity, specificity and accuracy of TA compared with SBA for detecting HL. Patient usability assessment of TA and SBA.Results129 patients were enrolled with 127 patients (254 ears) included in the final analysis. Median age was 43 years (IQR 33–56), 55% (70/127) were women. 76% (96/127) and 68% (86/127) of patients had HL defined by British Society of Audiology (BSA) and American Speech–Language–Hearing Association (ASHA) criteria. Age was significantly associated with HL (p<0.0001); however, hearing-related questionnaire scores were not significantly different between those with or without HL. There was no significant difference in detecting HL between TA and SBA using either BSA or ASHA criteria at each frequency. Overall, 92% (1612/1751) of TA results were within 10 dB agreement with SBA results. Sensitivity and specificity of TA for detecting HL were 77–100% and >85%, respectively, between 0.25 and 12.5 kHz. In terms of patient usability, TA showed significantly higher scores in attractiveness (p<0.0001), novelty (p<0.0001), efficiency (p=0.0003), stimulation (p=0.003) and perspicuity (p=0.02).ConclusionsTA demonstrated good sensitivity with high specificity for detecting HL at frequencies 0.25–12.5 kHz and would be an acceptable accurate alternative to SBA. This would increase the accessibility of HL screening and has the potential to be used as a diagnostic test in those without tinnitus where resources are limited.Trial registration numberNCT05847556.

Hearing loss is a major public health problem. In 2050, it could affect 2.5 billion people. It has therefore become necessary to prevent and diagnose them as early and as widely as possible. However, the costs of clinical equipment dedicated to the functional exploration of hearing remain high and hamper their distribution, while the technologies used are relatively basic. For example, the gold-standard pure-tone audiometry (PTA) essentially consists of emitting pure sounds. In addition, clinical audiometers are generally limited to PTA or few audiological tests, while hearing loss induce multiple functional deficits. Here, we present the Aupiometer, a low-cost audiometer implemented on a modular open-source system based on Raspberry Pi, and which integrates the entire technical framework necessary to carry out audiological measurements. Several hearing tests are already implemented (e.g. PTA, speech audiometry, questionnaires), while the clinical validity of the Aupiometer was verified on a panel of participants (N = 16) for an automated test of standard and extended high-frequency PTA, from 0.125 to 16 kHz, in comparison with a clinical audiometer. For this comparison between the two devices and over this wide frequency range, the difference is evaluated as less than ±10 dB for a 90% confidence interval, of the same order of magnitude as on test-retest differences on a single device. The interest of this device also extends to academic research as it should encourage the prototyping of innovative hearing tests by the community, in order to better understand the diversity of hearing problems in the population.

To investigate hearing and the take rate of crushed cartilage grafts in tympanoplasty. In this double-blinded, randomised, controlled trial, 46 patients with tympanic membrane perforation were enrolled. A conchal cartilage graft was used for reconstruction in both intervention and control groups. In the intervention group, crushed cartilage was used. The success rate and hearing results were ascertained every four months over a one-year follow-up period. A total of 36 patients - 20 in the intervention group and 16 in the control group - completed one year of follow up. There were no statistically significant differences between the two groups in mean air-bone gap, bone conduction threshold, speech discrimination score or speech reception threshold. The reduction in living cells after crushed cartilage tympanoplasty may decrease the rigidity and the volume of the graft, but may not necessarily improve the hearing results.

Localization accuracy and acuity for low- (0.375–0.75 kHz; LN) and high-frequency (2.25–4.5 kHz; HN) noise bands were examined in young (20–29 years) and older adults (65–83 years) in the acoustic free-field. A pointing task was applied to quantify accuracy, while acuity was inferred from minimum audible angle (MAA) thresholds measured with an adaptive 3-alternative forced-choice procedure. Accuracy decreased with laterality and age. From young to older adults, the accuracy declined by up to 23 % for the low-frequency noise band across all lateralities. The mean age effect was even more pronounced on MAA thresholds. Thus, age was a strong predictor for MAA thresholds for both LN and HN bands. There was no significant correlation between hearing status and localization performance. These results suggest that central auditory processing of space declines with age and is mainly driven by age-related changes in the processing of binaural cues (interaural time difference and interaural intensity difference) and not directly induced by peripheral hearing loss. We conclude that the representation of the location of sound sources becomes blurred with age as a consequence of declined temporal processing, the effect of which becomes particularly evident for MAA thresholds, where two closely adjoining sound sources have to be separated. While localization accuracy and MAA were not correlated in older adults, only a weak correlation was found in young adults. These results point to an employment of different processing strategies for localization accuracy and acuity.

Hearing impairments are typically assessed using pure tone audiometry, a diagnostic method that allows for the identification of the degree, type and configuration of hearing loss. The results of this assessment are generally displayed in the form of an audiogram, which graphically represents the softest sounds perceivable by an individual across a range frequencies. This paper presents a novel Open Source mobile application for the Android operating system that allows users to scan and analyse audiograms using a smartphone camera and subsequently classify the type of hearing loss. The application workflow is divided into three main stages: scanning, digitalization and classification of the audiogram. For this purpose, the application implements several artificial intelligence and image processing techniques, including YOLOv5, Optical Character Recognition (OCR) and Hough Transform. The scanned audiogram is analysed by a clinically validated AI model for classification of audiometric test results, providing clinicians with valuable assistance in formulating a diagnosis. All implemented algorithms and models were optimized for functionality on mobile devices. The application was evaluated on three distinct classes of smartphones across various price points, demonstrating its efficacy and consistent performance. The presented mobile application constitutes an advanced AI-driven decision support system that is readily accessible to general practitioners, otolaryngologists and audiologists. Its integration in medical facilities presents a substantial opportunity to decrease clinical workload, enhance diagnostic accuracy and reduce the likelihood of human error in hearing loss evaluations, which is particularly important in developing countries.

OBJECTIVES: To evaluate the functions of cochlear structures and the distal part of auditory nerve as well as dead regions within the cochlea in individuals with normal hearing with or without tinnitus by using electrophysiological tests. MATERIALS and METHODS: Nine individuals (ages: 21-59 years) with normal hearing with tinnitus were included in the study group. Thirteen individuals (ages: 25-60 years) with normal hearing without tinnitus were included in the control group. Immitancemetric examination, pure-tone audiometry (125Hz-16kHz), speech audiometry in quiet and noise environments, transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), threshold equalizing noise (TEN test (500Hz-4kHz), and ECochG tests, Beck Depression Questionnaire, Tinnitus Handicap Questionnaire, and Visual Analog Scale were performed. RESULTS: In the study group, three patients were found to have a minimal depression and six were found to have a mild depression. In pure-tone audiometry, the threshold (6-16 kHz) in the study group was significantly higher than that of the control group at all frequencies. In the study group, lower performance scores were obtained in speech discrimination in noise in both ears. In the control group, no dead region was detected in the TEN test whereas 75% of subjects in the study group had dead regions. DPOAE and TEOAE responses between study and control group subjects were not different. In the ECochG test, subjects in the study group showed an increase in the summating potential/action potential (SP/AP) ratio in both ears. CONCLUSION: Determination of the SP/AP ratio in patients with tinnitus may be useful in diagnosing hidden hearing loss. Detection of dead regions in 75% of patients in the TEN test may indicate that inner hair cells may be responsible for tinnitus. KEYWORDS: Cochlear synaptopathy, tinnitus, ECochG, TEN test, hidden hearing loss, high-frequency audiometry

Steroids are currently the most frequently accepted agents for idiopathic sudden sensorineural hearing loss (ISSNHL). However, the therapeutic effect of steroids is not always satisfactory. In this pilot study, we evaluated whether systemic treatment with Ginkgo biloba extract (EGb761) has an additive therapeutic effect in patients receiving a systemic steroid due to ISSNHL. A multicenter, randomized, double-blind clinical trial was performed. Fifty-six patients with ISSNHL were allocated to either EGb761 or placebo. In both groups, methylprednisolone was administered for 14 days. EGb761 was infused intravenously for 5 days in the EGb761 group, while the same amount of normal saline was infused in the placebo group. For the efficacy evaluation, pure-tone audiometry, speech audiometry, tinnitus handicap inventory (THI) and short form-36 health (SF-36) survey outcomes were obtained before administration and on days 3, 5, 14 and 28 of administration. Twenty-four patients in each group completed the study protocol. There was no difference in hearing loss between the two groups before treatment. At day 28, air conduction threshold values in the placebo and EGb761 groups were 34.63 ± 28.90 and 23.84 ± 25.42 dB, respectively ( p  = 0.082). Speech discrimination scores in the placebo and EGb761 groups were 69.17 ± 40.89 and 87.48 ± 28.65 %, respectively ( p  = 0.050). THI and SF-36 scores in the placebo and EGb761 groups were similar. Although a combination of steroid and EGb761 for initial treatment did not show better pure tone threshold, compared with steroid alone, speech discrimination was significantly improved in combination therapy. Further studies will be needed to know if addition of EGb761 actually improves the outcome of ISSNHL treatment.

Gastroesophageal reflux (GER) is considered a cause of otitis media with effusion (OME). This study aimed to investigate whether OME can be effectively treated with a proton pump inhibitor (PPI), therefore implicating GER as a causative factor of OME. A PPI or placebo was randomly administered to enrolled subjects for 4-8 weeks. To monitor effusion status, subjects underwent monthly pneumatic otoscopy and acoustic reflectometry. At enrollment and at completion of treatment, subjects underwent an audiogram and tympanogram for assessing changes in hearing due to altered fluid levels in the middle ear. After the treatment period, tympanostomy tube placement was recommended for subjects with unresolved effusion. This study enrolled 16 patients with an average age of 5.17 years. Between the treatment and placebo groups, there was no significant difference in the need for tympanostomy tubes. At completion of this study, patients receiving Lansoprazole demonstrated a significant improvement in pure tone average (p<0.01) and speech recognition thresholds (p=0.04). Four patients (25%) from the cohort dropped out of the study. Eight patients (50%) from the cohort required tympanostomy tube placement. Owing to difficulties with recruitment and small sample size, this study was unable to demonstrate the use of PPI in treating OME. A larger study is needed for further evaluation of this process.

True tinnitus is a phantom auditory perception arising from a source or trigger in the cochlea, brainstem, or at higher centers and has no detectable acoustic generator. The most accepted is the famous neurophysiologic model of Jastreboff, which stresses that tinnitus, is a subcortical perception and results from the processing of weak neural activity in the periphery. The aim of this study is to determine the role of Vitamin B12 in treatment of chronic tinnitus. In this randomized, double-blind pilot study, total 40 patients were enrolled, of which 20 in Group A (cases) received intramuscular therapy of 1 ml Vitamin B12 (2500 mcg) weekly for a period of 6 weeks and Group B (20) patients received placebo isotonic saline 01 ml intramuscular. The patients were subjected to Vitamin B12 assay and audiometry pre- and post-therapy. Of the total patients of tinnitus, 17 were Vitamin B12 deficient that is 42.5% showed deficiency when the normal levels were considered to be 250 pg/ml. A paired t-test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS) after Vitamin B12 therapy. This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus.

Background and Objectives: Labyrinthitis is an inflammatory inner ear disorder often resulting in acute vertigo and hearing loss. While typically self-limiting, some cases lead to persistent deficits. This study examined incidence trends of acute labyrinthitis before and after 2020 and compared hearing outcomes between these periods. Materials and Methods: This retrospective cohort study included 126 patients diagnosed with acute labyrinthitis at a tertiary medical center between January 2014 and May 2024. Patients were divided into pre-2020 (2014–2019) and post-2020 (2020–2024) cohorts. Poisson regression analyzed incidence trends, while audiometric outcomes were compared in 79 patients with complete 3-month follow-up data. Hearing recovery was assessed using pure-tone averages (PTA) across 500–4000 Hz, and predictors of persistent impairment were identified through multivariable logistic regression. Results: The cohort had a mean age of 47.8 years with female predominance (63.5%). Annual case counts increased significantly post-2020 (19.8 vs. 6.5 cases/year; CRR 3.05, 95% CI 2.07–4.57, p < 0.001). Substantial hearing improvement occurred across all frequencies (median AC improvement 13.8 dB). Hearing recovery was comparable between periods, with similar PTA improvements (−16.7 vs. −15.3 dB, p = 0.73) and equivalent distributions across World Health Organization (WHO) hearing categories (p = 0.64). Baseline hearing level was the strongest predictor of persistent impairment (OR 1.56 per 5 dB increase, 95% CI 1.25–1.95, p < 0.001), while age, sex, and diagnostic period showed no significant association. Among post-2020 patients, only 12.6% had confirmed coronavirus disease 19 (COVID-19), and no reliable association with hearing outcomes could be established due to substantial missing data. Conclusions: A significant increase in hospital-diagnosed labyrinthitis cases occurred following 2020, yet hearing outcomes at 3-month follow-up remained consistent with the pre-pandemic period. Baseline hearing level was the primary determinant of recovery, unaffected by demographic factors or diagnostic period. These findings suggest that while pandemic-related factors may have influenced case frequency, they did not alter auditory prognosis or recovery patterns.