Vinaya Manchaiah

Music exposure and hearing disorders : An overview

Abstract It has been generally accepted that excessive exposure to loud music causes various hearing symptoms (e.g. tinnitus) and consequently leads to a risk of permanent hearing damage, known as noise-induced hearing loss (NIHL). Such potential risk of NIHL due to loud music exposure has been widely investigated in musicians and people working in music venues. With advancements in sound technology and rapid developments in the music industry, increasing numbers of people, particularly adolescents and young adults, are exposing themselves to music on a voluntary basis at potentially harmful levels, and over a substantial period of time, which can also cause NIHL. However, because of insufficient audiometric evidence of hearing loss caused purely by music exposure, there is still disagreement and speculation about the risk of hearing loss from music exposure alone. Many studies have suggested using advanced audiological measurements as more sensitive and efficient tools to monitor hearing status as early indicators of cochlear dysfunction. The purpose of this review is to provide further insight into the potential risk of hearing loss caused by exposure to loud music, and thus contribute to further raising awareness of music induced hearing loss. Sumario Se ha aceptado en general que la exposición excesiva a música fuerte ocasiona varios síntomas auditivos (e.g. acúfeno) y consecuentemente trae el riesgo de daño auditivo permanente, conocido como hipoacusia inducida por ruido (NIHL). El riesgo potencial de NIHL debido a la exposición a música fuerte ha sido ampliamente investigado en músicos y en personas que trabajan en locales musicales. Con los avances en la tecnología del sonido y el rápido desarrollo de la industria musical, un mayor número de personas, en particular los adolescentes y los adultos jóvenes, se han expuesto voluntariamente a niveles potencialmente dañinos por tiempo considerable que pueden causar NIHL. Sin embargo, debido a que la evidencia audiométrica de que la exposición a música es la única causante de la pérdida auditiva es insuficiente, aun hay desacuerdo y especulación sobre el riesgo que esto representa. Varios estudios han sugerido monitorear el estado auditivo mediante herramientas audiológicas más sensitivas y eficientes, como indicadores tempranos de disfunción coclear. El objetivo de esta revisión es proveer un mayor conocimiento del riego potencial de hipoacusia debida a la exposición a música fuerte y por tanto contribuir a levantar una mayor conciencia sobre ello.

The genetic basis of auditory neuropathy spectrum disorder (ANSD).

OBJECTIVE Auditory neuropathy is a hearing disorder where outer hair cell function within the cochlea is normal, but inner hair cell and/or the auditory nerve function is disrupted. It is a heterogeneous disorder which can have either congenital or acquired causes. Furthermore, the aetiology of auditory neuropathy is vast, which may include prematurity, hyperbilirubinaemia, anoxia, hypoxia, congenital brain anomalies, ototoxic drug exposure, and genetic factors. It is estimated that approximately 40% of cases have an underlying genetic basis, which can be inherited in both syndromic and non syndromic conditions. This review paper provides an overview of the genetic conditions associated with auditory neuropathy spectrum disorders (ANSDs) and highlights some of the defective genes that have been found to be linked to the pathological auditory changes. METHOD Literature search was conducted using a number of resources including textbooks, professional journals and the relevant websites. RESULTS The largest proportion of auditory neuropathy spectrum disorders (ANSDs) is due to genetic factors which can be syndromic, non-syndromic or mitochondrial related. The inheritance pattern can include all the four main types of inheritances such as autosomal dominant, autosomal recessive, X-linked and mitochondrial. CONCLUSION This paper has provided an overview of mutation with some of the genes and/or loci discovered to be the cause for auditory neuropathy spectrum disorders (ANSDs). It has been noted that different gene mutations may trigger different pathological changes in patients with this disorder. These discoveries have provided us with vital information as to the sites of pathology in auditory neuropathy spectrum disorders (ANSDs), and the results highlight the heterogeneity of the disorder.

The patient journey of adults with hearing impairment: the patients' views

Clin. Otolaryngol. 2011, 36, 227–234

The role of communication partners in the audiological enablement/rehabilitation of a person with hearing impairment : An overview

Objective: Hearing impairment is known to have various effects upon both the person with hearing impairment (PHI) and their communication partners (CPs). In addition, CPs are reported to play an important role in making the decision to seek a consultation and the acceptance of intervention by the PHI. The overall aim of this paper is to provide a comprehensive overview of the role of the CP in the audiological enablement/rehabilitation of the PHI keeping clinical practice in focus. Method: A literature review was conducted using a number of resources including electronic databases, books and websites. Results: An overview of the literature was presented in the following sections: 1) Factors influencing the audiological enablement/rehabilitation of the PHI; 2) Effect of the PHIs hearing impairment on their CPs; 3) CPs’ influence on their PHIs audiological enablement/rehabilitation; 4) Positive experiences reported by CPs of the PHI; 5) Models to represent CPs within the social network context of the PHI; and 6) CP involvement in the audiological enablement/rehabilitation. This paper also identifies gaps in the literature and provides recommendations for further research. Conclusion: It is clear that involvement of the CP in the audiological enablement/rehabilitation can result in mutual advantages for both the PHI and their CPs.

Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: A systematic review

Abstract Objective: This systematic review aimed to explore the evidence on whether the preferred listening levels (PLLs) and durations of music listening through personal listening devices (PLDs) in adolescents and young adults exceed the current recommended 100% daily noise dose; together with the impact on hearing and possible influential factors of such listening behaviours. Design: A systematic search was conducted using multiple online bibliographic databases. Study sample: The 26 studies were included on the basis of the inclusion and exclusion criteria. Results: The results showed that up to 58.2% of participants exceeded the 100% daily noise dose, particularly in the presence of background noise. Significantly positive correlations were found among background noise levels and mean PLLs, as well as the proportion of participants exceeding the 100% daily noise dose. Moreover, significantly worse hearing thresholds were found in PLD users using audiometry, and significantly poor results in otoacoustic emission (OAE), even in the participants with self-reported ‘normal hearing’. Conclusion: It is crucial to develop appropriate standards and safe recommendations for daily music exposure dose in future studies. Providing an essential guide and effective education to adolescents and young adults will help raise awareness, increase knowledge, and consequently change attitudes and listening habits.

Exploring the influence of culture on hearing help-seeking and hearing-aid uptake

Abstract Objective: The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. Design: Information on audiological services in different countries and ‘theories related to cross-culture’ is presented, followed by a general discussion. Study sample: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Results: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. Conclusions: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.

Positive experiences associated with acquired hearing loss, Ménière's disease, and tinnitus: A review.

Abstract Objective: It is common to study and understand how various illness and disorders result in negative consequences. However, positive experiences have been reported in a range of disabling conditions including multiple sclerosis, heart disease, physical and sensory disabilities. This paper presents a literature review of studies that have explored positive experiences associated with acquired hearing loss, Ménières disease, and tinnitus. Design: A review of the peer reviewed scientific literature. Study sample: A comprehensive search strategy identified 15 articles after applying inclusion criteria. Results: A range of positive experiences have been reported by patients with hearing and balance disorders and by their significant others. Associations between demographic variables (e.g. age, gender), audiological variables (e.g. severity of the condition, duration) and the reported positive experiences are low. In Ménières disease, self-reported positive experiences can predict the impact of the condition. However, this phenomenon has not yet been demonstrated in relation to hearing loss and tinnitus. Conclusions: Positive experiences associated with audio-vestibular disorders have been demonstrated. Further research is needed on the long-term benefits of the encouragement of such experiences and positive attitudes in persons with hearing loss, tinnitus, and imbalance.

Social representation of hearing aids : cross-cultural study in India, Iran, Portugal, and the United Kingdom

Background The current study was aimed at understanding the social representation of hearing aids in India, Iran, Portugal, and the United Kingdom. We also compared these results to explore the cross-cultural differences and similarities among these countries. Methods The study involved a cross-sectional design, and the data were collected from four different countries using the snowball sampling method. Data were analyzed using a content analysis to identify the most-similar categories of responses reported, a co-occurrences analysis to see which of these categories are reported commonly, and a chi-square analysis to study if there was any association between positive, neutral, and negative connotations among participants in different countries. Results The current study revealed four different social representations of hearing aids from India, Iran, Portugal, and the United Kingdom, and also a global index. Conclusion The study results provide very useful insights into how hearing aids are represented in the society. These findings may have important implications for public education and also for manufacturers from the viewpoint of designing and marketing hearing aids in different countries.

Internet-Based Intervention for Tinnitus: Outcome of a Single-Group Open Trial

Background: Managing chronic tinnitus is challenging, and innovative ways to address the resulting health‐care burden are required. Internet‐based cognitive behavioral therapy (iCBT) for tinnitus shows promise as a cost‐effective treatment option. The feasibility and effectiveness of iCBT in the United Kingdom are yet to be explored. Furthermore, it is not known if iCBT can be supported by an audiologist rather than a psychologist. Purpose: This study aimed to determine the feasibility of guided iCBT using audiological support on tinnitus distress and tinnitus‐related comorbidities. Furthermore, it aimed to establish the feasibility of iCBT for tinnitus distress in the United Kingdom, by determining recruitment, attrition, and compliance rates. Finally, it aimed to identify which aspects of the protocol require refinement for subsequent clinical trials. Research Design: A single‐group open trial design was implemented. This study would serve as a prerequisite study, to identify barriers, before undertaking effectiveness trials. Study Sample: Participants consisted of 37 adults (18 males, 19 females), with an age range of between 50 and 59 yr. The mean preintervention tinnitus severity rating was 56.15 (standard deviation = 18.35), which is categorized as “severe tinnitus” as measured by the Tinnitus Functional Index (TFI). Five participants withdrew during the study, and 29 of the remaining participants completed the postintervention questionnaire. Intervention: The guided iCBT intervention ran over an eight‐week period and consisted of 16 obligatory modules and five optional modules. The intervention was designed to be interactive, interesting, and stimulating. A key element was the provision of support from an audiologist throughout the program. Data Collection and Analysis: Online questionnaires were used throughout the study. These were administered at baseline and postintervention to determine attrition and compliance rates and to facilitate sample size estimates for further clinical trials. Outcome measures for tinnitus severity, hearing handicap, insomnia, cognitive functioning, hyperacusis, anxiety, depression, and life satisfaction were used to investigate the effects of iCBT with audiological support. In addition, a weekly questionnaire was incorporated to monitor change in tinnitus distress while undertaking the intervention. Results: Feasibility was established using an audiologist to support this guided iCBT intervention, as a significant change postintervention was found for tinnitus severity, as measured by the TFI and the Tinnitus Handicap Inventory, Screening version. The attrition rate was 22% and compliance was variable. Although these results were based on a small sample, they provide encouraging evidence for the feasibility of delivering iCBT treatment for tinnitus symptoms with audiology support in the United Kingdom. Conclusions: An Internet‐based intervention of tinnitus appears to be feasible in the United Kingdom when using audiological support. Randomized controlled trials to further investigate the effectiveness of iCBT for tinnitus in the United Kingdom are required.

Perspectives on defining ‘hearing loss’ and its consequences

Abstract Objective: This discussion paper aims to highlight factors that may be important in defining hearing loss and its consequences and to present different perspectives based on various models of disability. Method: Relevant literature was reviewed to develop the discussion. Results: Hearing is a complex function that has both cognitive and emotional aspects. A person with hearing loss may have consequences in the physical, mental and social domains. Hearing loss in the context of clinical audiology is currently defined based on type of pathology and severity. However, evidence from both clinical findings and research suggest that this may not cover all the aspects of ‘hearing loss’ as a disability. Conclusion: Defining and describing hearing loss and its consequences with a holistic approach has some clinical value particularly in the context of audiological enablement/rehabilitation.