The effects of N95 mask and face shield on speech perception among healthcare workers in the coronavirus disease 2019 pandemic scenario

ObjectiveThe current circumstances of the coronavirus disease 2019 pandemic necessitate the use of personal protective equipment in hospitals. N95 masks and face shields are being used as personal protective equipment to protect from aerosol-related spread of infection. Personal protective equipment, however, hampers communication. This study aimed to assess the effect of using an N95 mask and face shield on speech perception among healthcare workers with normal hearing.MethodsTwenty healthcare workers were recruited for the study. Pure tone audiometry was conducted to ensure normal hearing. Speech reception threshold and speech discrimination score were obtained, first without using personal protective equipment and then repeated with the audiologist wearing an N95 mask and face shield.ResultsA statistically significant increase in speech reception threshold (mean of 12.4 dB) and decrease in speech discrimination score (mean of 7 per cent) was found while using the personal protective equipment.ConclusionUse of personal protective equipment significantly impairs speech perception. Alternate communication strategies should be developed for effective communication.

Words in noise audiometry in adult subjects with normal hearing

Background: Patients with hearing disturbance will generally undergo pure tone audiometry andspeech audiometry in a quiet room, but those examinations cannot evaluate the ability to understand speech in daily environment with a noisy background. Words in noise test will provide valuable informationregarding patient’s hearing problem in noise. Purpose: To evaluate the hearing threshold using wordsin noise test in adults with normal hearing. Method: This cross-sectional study was conducted in CiptoMangunkusumo Hospital from January to April 2017. All subjects who fulfilled the inclusion and exclusioncriteria underwent pure tone audiometry, speech audiometry, and words in noise test. Results: A total of71 individuals with normal hearing were recruited for this study. Words in noise test showed the medianvalue of 67 dB and 100 dB for Speech Recognition Threshold (SRT) 50% and Speech DiscriminationScore (SDS) 100%, respectively. The SRT 50% and SDS 100% were significantly higher in the age group40–60 years compared to the age group 18–39 years. There was also a statistically significant differencebetween males and females at SRT 50% assessed by words in noise audiometry. Conclusion: Wordsin noise test showed a statistically significant difference in SRT 50% and SDS 100% between two agegroups, but no difference was found between genders. The result of this study can be used as a referencefor SRT and SDS values of speech audiometry test in noise.Keywords: words in noise, speech audiometry, speech recognition threshold, speech discrimination score ABSTRAKLatar belakang: Pasien dengan gangguan pendengaran umumnya menjalani pemeriksaanaudiometri nada murni dan audiometri tutur di ruangan yang sunyi, tetapi pemeriksaan ini tidakdapat menggambarkan kemampuan pemahaman wicara di lingkungan sehari-hari yang ramai. Testutur dalam bising dapat mengevaluasi masalah pendengaran pasien dalam keadaan bising. Tujuan:Untuk mengevaluasi ambang pendengaran menggunakan tes tutur dalam bising pada orang dewasadengan pendengaran normal. Metode: Penelitian potong lintang ini dilakukan di Rumah Sakit CiptoMangunkusumo dari Januari hingga April 2017. Semua subjek yang memenuhi kriteria inklusi daneksklusi menjalani pemeriksaan audiometri nada murni, audiometri tutur, dan tes tutur dalam bising.Hasil: Sebanyak 71 orang dengan pendengaran normal diikutsertakan dalam penelitian ini. Tes tuturdalam bising menunjukkan nilai median masing-masing 67 dB dan 100 dB pada Speech RecognitionThreshold (SRT) 50% dan Speech Discrimination Score (SDS) 100%. SRT 50% dan SDS 100% secarasignifikan lebih tinggi pada kelompok usia 40–60 tahun dibandingkan dengan kelompok usia 18–39 tahun. Hasil pemeriksaan tes tutur dalam bising menunjukkan perbedaan yang signifikan antara laki-laki dan wanita pada nilai SRT 50%. Kesimpulan: Tes tutur dalam bising menunjukkan perbedaan yang bermakna secara statistik pada SRT 50% dan SDS 100% antara dua kelompok umur, tetapi tidak ada perbedaan signifikan diantara jenis kelamin. Hasil penelitian ini dapat digunakan sebagai acuan untuk nilai SRT dan SDS pada pemeriksaan audiometri tutur dalam bising.

Influence of temporal resolution skills in speech discrimination abilities of older subjects

Un alterata capacità di risoluzione temporale del sistema uditivo può essere uno dei fattori alla base della ridotta discriminazione verbale nei soggetti anziani. Ben pochi studi in passato hanno approfondito questo aspetto in modo sistematico. Il presente studio si è pertanto posto come obiettivi: 1) Stabilire una normativa in una popolazione di anziani in un contesto culturale Indiano per il test Gaps in Noise (GIN); 2) Stabilire la relazione fra la discriminazione verbale e le capacità di risoluzione temporale in una popolazione di individui anziani normo udenti. Sono stati arruolati complessivamente trenta pazienti anziani normo udenti (età: 55-75 anni; età media: 59,86 ± 4,11 anni). La valutazione audiologica si è composta di una timpanometria, audiometria tonale e vocale (Speech Reception Threshold-SRT, Speech Discrimination Score-SDS) e il GIN. I risultati del presente studio ci hanno permesso di determinare per la popolazione studiata un GDT (Gap Detection Threshold) medio di 8,7 millisecondi (SD : 3,38) per l’orecchio destro e di 8,83 millisecondi (SD : 2,86) per l’orecchio sinistro. Il TPS (Total Percentage Score) medio per l’orecchio destro è stato del 47% (SD : 11,92) e per l’orecchio sinistro del 45% (SD : 11,29). I nostri risultati suggeriscono che le abilità di discriminazione temporale siano peggiori nei soggetti anziani rispetto ai soggetti giovani e adulti. Né il TPS né il GDT hanno mostrato differenze interaurali significative. Il GDT ha presentato una correlazione inversa con le performance di discriminazione verbale. Il TPS ha mostrato una correlazione diretta con l’SDS. Il presente studio dimostra in modo chiaro la relazione che intercorre fra la discriminazione verbale e le abilità di risoluzione temporale. Il presente database di dati rappresenta una risorsa per la valutazione delle abilità di risoluzione temporale in soggetti anziani affetti da ipoacusia. Riteniamo che tutti i soggetti anziani vadano sottoposti a una valutazione delle abilità di risoluzione temporale nel corso di una valutazione dell’udito, indipendentemente dal fatto che siano o meno affetti da alterazioni uditive.

Intratympanic steroid injection as a salvage treatment for sudden sensorineural hearing loss

Objective:To determine the efficacy of intratympanic methylprednisolone injections for treating sudden sensorineural hearing loss.Method:A retrospective chart review was performed to identify patients suffering from sudden sensorineural hearing loss with no recovery after oral steroids. Patients were given up to three intratympanic methylprednisolone injections at one-week intervals. They were classified according to their functional hearing class, remission was monitored and potential factors affecting prognosis were analysed.Results:Intratympanic injections provide effective salvage therapy for sudden sensorineural hearing loss (p = 0.039). Changes in pure tone average and speech discrimination score were analysed following intratympanic methylprednisolone injections. The pure tone average reached a plateau after the second injection; however, the speech discrimination score improved until after the third injection. Hearing improvement after intratympanic injections mainly occurred at low frequencies. The interval between symptoms appearing and intratympanic injections starting was not significantly associated with remission (p = 0.680).Conclusion:A delay between symptom onset and the first intratympanic methylprednisolone injection does not seem to affect prognosis.

Effect of vents on the output of hearing Aids

The aim of the study was to explore the effect of vents on the speech discrimination scores and electroacoustic characteristics of body level hearing aids. The Nineteen adults who participated in the study had mild to moderate sloping sensori-neural hearing loss and were in the age range of 18-70 years. Apart from 19 hearing aids users additional 11 hearing aids were also taken for the study of electro-acoustic characteristics only. Major changes in the electroacoustic characteristics of the body worn hearing aids was observed on HFA OSPL90, FOG and EINL which reduced to 7.31%, 9.19% and 7.72% when parallel vent of 2mm were bored in the regular ear moulds respectively. Parallel/ Diagonal vents improved the Speech Discrimination score by 9%. The cumulative impact of venting can be seen on improvement of speech discrimination scores and subjective impression of clear speech.DOI: http://dx.doi.org/10.3329/bjo.v18i1.10420 Bangladesh J Otorhinolaryngol 2012; 18(1): 59-62

Hearing preservation in surgery for large vestibular schwannomas

Object Hearing preservation remains a challenging problem in vestibular schwannoma (VS) surgery. The ability to preserve hearing in patients with large tumors is subject to particular difficulty. In this study, the authors focus on hearing preservation in patients harboring large VSs. Methods A total of 344 consecutive patients underwent surgical removal of VSs over the past 9 years. Of these 344 cases, 195 VSs were > 20 mm in maximum cisternal diameter. Of the 195 cases, hearing preservation surgery was attempted for 54 patients who had a Class A, B, C, or D preoperative hearing level; that is, a pure tone average ≤ 60 dB and speech discrimination score ≥ 50% according to the Sanna/Fukushima classification. The tumors were classified as moderately large (21–30 mm based on the largest extrameatal diameter), large (31–40 mm), and giant (≥ 41 mm) according to the international criteria. The authors categorized patients with Class A, B, C, D, or E hearing (pure tone average ≤ 80 dB and speech discrimination score ≥ 40%) as having preserved hearing postoperatively. Results Forty-one tumors (75.9%) were totally removed and 13 (24.1%) had near-total removal. Of the 54 patients, 29 maintained their hearing postoperatively; the overall hearing preservation rate was 53.7%. Analysis based on the preoperative hearing level showed that hearing was preserved in 14 (77.8%) of 18 cases for Class A; in 8 (47.1%) of 17 cases for Class B; in 4 (57.1%) of 7 cases for Class C; and in 3 (25.0%) of 12 cases for Class D. In addition, according to the analysis based on the tumor size, 20 (52.6%) of 38 patients with moderately large tumors retained their hearing, as did 5 (50.0%) of 10 patients with large tumors and 4 (66.7%) of 6 patients with giant tumors. Complications included 2 cases of bacterial meningitis that were cured by intravenous injection of antibiotics, 3 cases of subcutaneous CSF leakage that resolved without any surgical repair, and 1 case of temporary abducent nerve palsy. There were no deaths in this series. Conclusions The results indicate that successful hearing preservation surgery in large VSs is possible with meticulous technique and attention to adhesions between the tumor and the cochlear nerves.