Christopher Spankovich

Evidence of “hidden hearing loss” following noise exposures that produce robust TTS and ABR wave-I amplitude reductions

ABSTRACT In animals, noise exposures that produce robust temporary threshold shifts (TTS) can produce immediate damage to afferent synapses and long‐term degeneration of low spontaneous rate auditory nerve fibers. This synaptopathic damage has been shown to correlate with reduced auditory brainstem response (ABR) wave‐I amplitudes at suprathreshold levels. The perceptual consequences of this “synaptopathy” remain unknown but have been suggested to include compromised hearing performance in competing background noise. Here, we used a modified startle inhibition paradigm to evaluate whether noise exposures that produce robust TTS and ABR wave‐I reduction but not permanent threshold shift (PTS) reduced hearing‐in‐noise performance. Animals exposed to 109 dB SPL octave band noise showed TTS >30 dB 24‐h post noise and modest but persistent ABR wave‐I reduction 2 weeks post noise despite full recovery of ABR thresholds. Hearing‐in‐noise performance was negatively affected by the noise exposure. However, the effect was observed only at the poorest signal to noise ratio and was frequency specific. Although TTS >30 dB 24‐h post noise was a predictor of functional deficits, there was no relationship between the degree of ABR wave‐I reduction and degree of functional impairment. HighlightsNoise burst prepulse inhibition was used to assess hearing‐in‐noise deficits.Temporary threshold shift >30 dB produced hearing‐in‐noise deficits 2 weeks post‐noise.Temporary threshold shift >30 dB produced long term ABR wave‐I amplitude reductions.The degree of ABR wave‐I reduction was not correlated with degree of hearing‐in‐noise deficits.The degree of temporary threshold shift was not correlated with degree of hearing‐in‐noise deficits.

Differential effects of suppressors on hazardous sound pressure levels generated by AR-15 rifles: Considerations for recreational shooters, law enforcement, and the military

Abstract Objective: Firearm discharges produce hazardous levels of impulse noise that can lead to permanent hearing loss. In the present study, we evaluated the effects of suppression, ammunition, and barrel length on AR-15 rifles. Design: Sound levels were measured left/right of a user’s head, and 1-m left of the muzzle, per MIL-STD-1474-D, under both unsuppressed and suppressed conditions. Study sample: Nine commercially available AR-15 rifles and 14 suppressors were used. Results: Suppressors significantly decreased peak dB SPL at the 1-m location and the left ear location. However, under most rifle/ammunition conditions, levels remained above 140 dB peak SPL near a user’s right ear. In a subset of conditions, subsonic ammunition produced values near or below 140 dB peak SPL. Overall suppression ranged from 7–32 dB across conditions. Conclusions: These data indicate that (1) suppressors reduce discharge levels to 140 dB peak SPL or below in only a subset of AR-15 conditions, (2) shorter barrel length and use of muzzle brake devices can substantially increase exposure level for the user, and (3) there are significant left/right ear sound pressure differences under suppressed conditions as a function of the AR-15 direct impingement design that must be considered during sound measurements to fully evaluate overall efficacy.

Relationship between dietary quality, tinnitus and hearing level: data from the national health and nutrition examination survey, 1999–2002

Abstract Objective: To examine the relationship between the healthy eating index (HEI), a measure of dietary quality based on United States Department of Agriculture recommendations and report of tinnitus. Design: This cross-sectional analysis was based on HEI data and report of tinnitus. Study sample: Data for adults between 20 and 69 years of age were drawn from the National Health and Nutrition Examination Survey (NHANES), 1999–2002. The NHANES is a programme of studies, to assess the health and nutritional status of adults and children in the United States. Two thousand one hundred and seventy-six participants were included in the analytic sample. Results: Of the sample, 21.1% reported tinnitus within the past year and 11.7% reported persistent tinnitus, defined as tinnitus experienced at least monthly or greater. Controlling for age, sex, race/ethnicity, diabetes, noise exposure and smoking status, we found that with healthier diet (poorer vs. better HEI) there was decreased odds of reported persistent tinnitus [odds ratio (OR); 0.67; 95% confidence interval (CI) 0.45–0.98; p = 0.03].Conclusions: The current findings support a possible relationship between healthier diet quality and reported persistent tinnitus.

Profile Analysis of Psychological Symptoms Associated With Misophonia: A Community Sample

Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.

Relationship of stroke risk and hearing loss in African Americans: The Jackson Heart Study

To evaluate the relationships among measures of stroke risk and hearing in an African American cardiovascular study cohort.

Is weight a predictive risk factor of postoperative tonsillectomy bleed?: Weight predictive of tonsil bleed

To determine if a correlation exists between weight‐for‐age percentile and post‐tonsillectomy hemorrhage in the pediatric population.

Tinnitus and its risk factors in african americans: The Jackson Heart Study: Tinnitus Risk Factors in African Americans

To describe the prevalence of reported tinnitus and tinnitus handicap in the all–African American Jackson Heart Study (JHS) cohort, with assessment of the relationship to cardiometabolic risk and depression.

Early Indices of Reduced Cochlear Function in Young Adults with Type-1 Diabetes Revealed by DPOAE Fine Structure

BACKGROUND The relationship between type-1 diabetes mellitus (DM) and cochlear dysfunction remains inconclusive. PURPOSE The purpose of this study was to examine otoacoustic emissions (OAEs) in normal-hearing young adults with type-1 DM as compared with matched controls and identify potential covariates influencing OAE findings. RESEARCH DESIGN Cross-sectional study. STUDY SAMPLE N = 40 young adults aged 18-28 years including individuals with type-1 DM (n = 20) and age-gender matched controls (n = 20) with normal hearing sensitivity. DATA COLLECTION AND ANALYSIS Measures of pure-tone threshold sensitivity and OAEs, including distortion product otoacoustic emissions (DPOAEs), transient evoked OAEs, and DPOAE fine structure, were compared between groups. Covariates such as noise exposure and DM-related factors (e.g., duration of disease, glycated hemoglobin levels) were considered. Statistical analysis included analysis of variance and linear regression. RESULTS Measures of hearing sensitivity and auditory function in both groups were comparable for all assays, except DPOAE fine structure. A reduced number of fine structure peaks and component amplitudes were found in the type-1 diabetes DM group with the primary difference in the reflection component. CONCLUSIONS The results indicate that reduced cochlear function in young adults with type-1 DM can be revealed using DPOAE fine structure, suggesting potential clinical applications of DPOAE fine structure in early identification of cochlear pathology. Potential factors underlying these findings are discussed.

The effect of continuous positive airway pressure therapy on nasal patency: Effect of CPAP therapy on nasal patency

Nasal congestion and obstruction are reported in the majority of continuous positive airway pressure (CPAP) users and are frequently cited as reasons for noncompliance. To our knowledge, no study has demonstrated a change in objective or subjective nasal patency in patients with obstructive sleep apnea (OSA) after a therapeutic trial of CPAP therapy.

Self reported hearing difficulty, tinnitus, and normal audiometric thresholds, the National Health and Nutrition Examination Survey 1999–2002

Abstract Perceived hearing difficulty (HD) and/or tinnitus in the presence of normal audiometric thresholds present a clinical challenge. Yet, there is limited data regarding prevalence and determinant factors contributing to HD. Here we present estimates generalized to the non‐institutionalized population of the United States based on the cross‐sectional population‐based study, the National Health and Nutrition and Examination Survey (NHANES) in 2176 participants (20–69 years of age). Normal audiometric thresholds were defined by pure‐tone average (PTA4) of 0.5, 1.0, 2.0, 4.0 kHz ≤ 25 dBHL in each ear. Hearing difficulty (HD) and tinnitus perception was self‐reported. Of the 2176 participants with complete data, 2015 had normal audiometric thresholds based on PTA4; the prevalence of individuals with normal PTA4 that self‐reported HD was 15%. The percentage of individuals with normal audiometric threshold and persistent tinnitus was 10.6%. Multivariate logistic regression adjusting for age, sex, and hearing thresholds identified the following variables related to increased odds of HD: tinnitus, balance issues, noise exposure, arthritis, vision difficulties, neuropathic symptoms, physical/mental/emotional issues; and for increased odds or reported persistent tinnitus: HD, diabetes, arthritis, vision difficulties, confusion/memory issues, balance issues, noise exposure, high alcohol consumption, neuropathic symptoms and analgesic use. Analyses using an alternative definition of normal hearing, pure‐tone thresholds ≤25 dBHL at 0.5, 1.0, 2.0, 4.0, 6.0, and 8.0 kHz in each ear, revealed lower prevalence of HD and tinnitus, but comparable multivariate relationships. The findings suggest that prevalence of HD is dependent on how normal hearing is defined and the factors that impact odds of reported HD include tinnitus, noise exposure, mental/cognitive status, and other sensory deficits. HighlightsThe prevalence of hearing difficulty (HD) and persistent tinnitus (PT) was 15% and 10.6% limited to persons with normal audiometric thresholds.The prevalence was dependent on how normal audiometric threshold was defined. More stringent criteria resulted in lower prevalence estimates.Multivariate models indicated tinnitus, balance, noise, arthritis, vision, neuropathy, and physical/mental issues were related to HD.Multivariate models indicated HD, diabetes, balance, noise, arthritis, vision, neuropathy, and analgesics were related to PT.