• Journal of Audiology & Otology
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• 제24권1호
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• pp.29-34
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• 2020

Background and Objectives: Bilateral microphones with contralateral routing of signal (BiCROS) hearing aid is an option for hearing rehabilitation in individuals with asymmetric sensorineural hearing loss (ASNHL). The clinical factors influencing the trial and purchase of BiCROS were investigated. Subjects and Methods: We reviewed the medical records of 78 patients with ASNHL who were recommended to use BiCROS and analyzed the demographic and audiological factors influencing the trial and purchase of BiCROS. Results: Among the 78 patients, 52 (66.7%) availed of the free BiCROS trial and 21 (26.9%) purchased BiCROS. The mean pure tone audiometry (PTA) air conduction (AC) threshold of the better- and worse-hearing ears were 44.2±12.8 dB and 90.7±22.5 dB HL, respectively. The decision for trial or purchase of BiCROS was not influenced by age, sex, duration of hearing loss of the worse-hearing ear, or PTA AC threshold or speech discrimination score of both ears. The first and third quartiles of the PTA AC thresholds for the better-hearing ear of BiCROS buyers were 38.75 dB and 53.75 dB HL, respectively. The counterpart values for the worse-hearing ear were 72.50 dB and 118.75 dB HL, respectively. Conclusions: The clinical factors analyzed in this study were found to be irrelevant to the trial and purchase of BiCROS in patients with ASNHL. Nevertheless, the distribution range of the auditory thresholds of the subjects using BiCROS can be a useful basis for the counseling of patients with ASNHL and selection of candidates for BiCROS use.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1978년도 제12차 학술대회연제 순서 및 초록
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• pp.8.3-8
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• 1978

부음기관의 기능이 정상인 경우 1,000Hz 이하의 저음역에서 골도관치는 외이도를 폐새 하였을 때와 개방하였을 때 약 20dB의 차이를 나타낸다. 그러나 외이도를 폐색하였을 때나 개방하였을 때 골도관치에 변화가 없으면 전음기관에 병변이 있음을 의미한다. 1891년에 Bing이 처음으로 외이도폐색에 의한 골도검사를 발표한 이래 여러 학자들에 의하여 본검사가 유용한 임상경력검사의 한방법으로서 인정되고Bing test로 알려지고 있다. Sullivan은 1947년에 250Hz, 500Hz, 1,000Hz에서 외이도를 폐색하였을 때와 개방하였을 때의 골도관치의 차이를 합한 것을 "Occlusion Index"라고 명명하였다. 이에 저자들은 bing test의 임상청각학적 의의를 검토하고자 정상인 40이, 만성중이염환자 20이, 감각신경성난청환자 14이를 대상으로 순음청력검사, Bing test및 impedance audiometry를 시행하고 occlusion index와의 상관관계를 검토하여 다음과같은 결과를 얻었다. 1. Occlusion index는 정상인 40좌에서는 $33.10\pm1.68dB,$ 만성중이염환자 20이에서는 $3.10\pm0.69dB,$ 감각신경성난청환자 14이에서는 28.10=4.05 dB이었다. 2. 정상인 40이의 static compliance는 범위가 0.22~0.75cc, 평균치가 0.64cc, 5.D가 0.05이었다. 3. Static compliance가 작을수록 occlusion index는 컸고, static compliance가 클수록 occlusion index 는 작아지는 영향을 나타내고 있음을 관찰하였다.

• Journal of Audiology & Otology
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• 제25권4호
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• pp.217-223
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• 2021

Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.

• 대한청각학회지
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• 제25권4호
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• pp.217-223
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• 2021

Background and Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation. Subjects and Methods: All patients received implants of the same brand. Pre and postoperative Categories of Auditory Performance score and aided free-field pure tone audiometry thresholds were noted. In vivo integrity tests were performed for each patient and the results of ex vivo tests of each implant were obtained from manufacturer. Results: A total of 149 CIs were placed in 121 patients aged <18 years. The revision rate in children was 6.7% (10/121 children). Six patients had a history of head injury leading to a hard failure. The causes of reimplantation in others were soft failure (n=1), electrode migration (n=1), infection (n=1), and other (n=1). All patients showed better or similar postreimplantation audiological performance compared with pre-reimplantation results. Conclusions: It is very important to provide a safe school and home environment and educate the family for reducing reimplantation due to trauma. Especially for active children, psychiatric consultation should be continued postoperatively.

• 한국안광학회지
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• 제14권3호
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• pp.89-93
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• 2009

목적: 본 연구는 굴절교정된 정상안에서 운무 전후에 따른 순음청력검사 값의 변화를 알아보고자 시행하였다. 방법: 안질환이나 청각질환이 없으며, 교정시력이 1.0이상의 젊은 성인 50명(남자: 30명, 여자: 20명)을 대상으로 하였다. 시력교정 전후의 순음청력역치(pure tone threshold)의 변화를 순음청력검사(pure tone audiometry)를 통해서 비교해 보고자 하였다. 결과: 전 주파수 대역에서 운무 후의 순음청력역치가 운무 전보다 더 높게 나타났으며, 그 차이는 2000 Hz를 제외한 전 주파수 대역에서 통계적으로 유의하게 측정되었다(p<.05). 저주파수 대역인 250 Hz와 500 Hz에서 각각 6.8${\pm}$8.4 dBHL과 4.3${\pm}$6.6 dBHL로 나타나 다른 주파수 대역에 비해서 그 차이가 크게 나타났고, 중주파수 대역인 2000 Hz에서는 0.8${\pm}$4.5 dBHL로 가장 작게 나타났다. 결론: 굴절교정된 정상인에서 운무 전과 후의 순음청력검사의 역치값이 다르게 나타나 망막상의 선명도와 청각은 서로 영향을 주는 것으로 판단되며 이 결과는 굴절교정과 청각의 상관성을 제공하는 기초자료로 활용될 수 있을 것으로 사료된다.

• 대한청각학회지
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• 제24권1호
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• pp.29-34
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• 2020

Background and Objectives: Bilateral microphones with contralateral routing of signal (BiCROS) hearing aid is an option for hearing rehabilitation in individuals with asymmetric sensorineural hearing loss (ASNHL). The clinical factors influencing the trial and purchase of BiCROS were investigated. Subjects and Methods: We reviewed the medical records of 78 patients with ASNHL who were recommended to use BiCROS and analyzed the demographic and audiological factors influencing the trial and purchase of BiCROS. Results: Among the 78 patients, 52 (66.7%) availed of the free BiCROS trial and 21 (26.9%) purchased BiCROS. The mean pure tone audiometry (PTA) air conduction (AC) threshold of the better- and worse-hearing ears were 44.2±12.8 dB and 90.7±22.5 dB HL, respectively. The decision for trial or purchase of BiCROS was not influenced by age, sex, duration of hearing loss of the worse-hearing ear, or PTA AC threshold or speech discrimination score of both ears. The first and third quartiles of the PTA AC thresholds for the better-hearing ear of BiCROS buyers were 38.75 dB and 53.75 dB HL, respectively. The counterpart values for the worse-hearing ear were 72.50 dB and 118.75 dB HL, respectively. Conclusions: The clinical factors analyzed in this study were found to be irrelevant to the trial and purchase of BiCROS in patients with ASNHL. Nevertheless, the distribution range of the auditory thresholds of the subjects using BiCROS can be a useful basis for the counseling of patients with ASNHL and selection of candidates for BiCROS use.

• Journal of Audiology & Otology
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• 제23권2호
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• pp.69-75
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• 2019

Background and Objectives: The antioxidant ebselen will be able to limit or prevent the ototoxicity arising from 2-hydroxypropyl-β-cyclodextrin (HPβCD). Niemann-Pick Type C (NPC) disease is a disorder of lysosomal storage manifested in sphingolipidosis. Recently, it was noted that experimental use of HPβCD could partially resolve the symptoms in both animals and human patients. Despite its desirable effect, HPβCD can induce hearing loss, which is the only major side effect noted to date. Understanding of the pathophysiology of hearing impairment after administration of HPβCD and further development of preventive methods are essential to reduce the ototoxic side effect. The mechanisms of HPβCD-induced ototoxicity remain unknown, but the resulting pathology bears some resemblance to other ototoxic agents, which involves oxidative stress pathways. To indirectly determine the involvement of oxidative stress in HPβCD-induced ototoxicity, we tested the efficacy of an antioxidant reagent, ebselen, on the extent of inner ear side effects caused by HPβCD. Materials and Methods: Ebselen was applied prior to administration of HPβCD in mice. Auditory brainstem response thresholds and otopathology were assessed one week later. Bilateral effects of the drug treatments also were examined. Results: HPβCD-alone resulted in bilateral, severe, and selective loss of outer hair cells from base to apex with an abrupt transition between lesions and intact areas. Ebselen co-treatment did not ameliorate HPβCD-induced hearing loss or alter the resulting histopathology. Conclusions: The results indirectly suggest that cochlear damage by HPβCD is unrelated to reactive oxygen species formation. However, further research into the mechanism(s) of HPβCD otopathology is necessary.

• 대한청각학회지
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• 제23권2호
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• pp.69-75
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• 2019

Background and Objectives: The antioxidant ebselen will be able to limit or prevent the ototoxicity arising from 2-hydroxypropyl-β-cyclodextrin (HPβCD). Niemann-Pick Type C (NPC) disease is a disorder of lysosomal storage manifested in sphingolipidosis. Recently, it was noted that experimental use of HPβCD could partially resolve the symptoms in both animals and human patients. Despite its desirable effect, HPβCD can induce hearing loss, which is the only major side effect noted to date. Understanding of the pathophysiology of hearing impairment after administration of HPβCD and further development of preventive methods are essential to reduce the ototoxic side effect. The mechanisms of HPβCD-induced ototoxicity remain unknown, but the resulting pathology bears some resemblance to other ototoxic agents, which involves oxidative stress pathways. To indirectly determine the involvement of oxidative stress in HPβCD-induced ototoxicity, we tested the efficacy of an antioxidant reagent, ebselen, on the extent of inner ear side effects caused by HPβCD. Materials and Methods: Ebselen was applied prior to administration of HPβCD in mice. Auditory brainstem response thresholds and otopathology were assessed one week later. Bilateral effects of the drug treatments also were examined. Results: HPβCD-alone resulted in bilateral, severe, and selective loss of outer hair cells from base to apex with an abrupt transition between lesions and intact areas. Ebselen co-treatment did not ameliorate HPβCD-induced hearing loss or alter the resulting histopathology. Conclusions: The results indirectly suggest that cochlear damage by HPβCD is unrelated to reactive oxygen species formation. However, further research into the mechanism(s) of HPβCD otopathology is necessary.

• 한국산업보건학회지
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• 제33권3호
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• pp.332-345
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• 2023

Objectives: We examined the association of hearing with cardio-metabolic diseases, dyslipidemia, hypertension and diabetes mellitus according to the personal and occupational characteristics of workers exposed to noise. Methods: The subjects of the study were 237,028 workers who underwent 2, 3, and 4 kHz airway pure tone audiometry in 2015 and who underwent clinical tests to diagnose cardiovascular-metabolic diseases. Cardiovascular-metabolic diseases were defined using reference values for respective items including blood pressure (systolic/diastolic), fasting blood glucose, cholesterol, and triglycerides. The airway pure tone hearing threshold of 2, 3, and 4 kHz, the average threshold of 2-3-4 kHz, and the hearing loss by the average threshold of the primary examination were distinguished. Results: Workers with cardiovascular-metabolic disease had significantly higher average hearing thresholds and higher rates of hearing loss. Logistic regression analysis, which adjusted for demographic variables of gender and age and occupational variables such as workplace size, industry, and type of work, and cardiovascular-metabolic disease as independent variables, showed that the odds ratio of hypertension to hearing loss in the mid-frequency was 1.239 (95% confidence interval: 1.118-1.374). For hypertension was 1.159 (1.107-1.214) and for diabetes it was 1.166 (1.104-1.230) for hearing loss in the high-frequency. Hearing loss measured by mean hearing was 1.178 (1.105-1.256) for hypertension and 1.181 (1.097-1.271) for diabetes. Conclusions: Cardiovascular-metabolic diseases in noise-exposed workers are associated with an increased risk of hearing loss and should be accompanied by bio-monitoring of cardiovascular-metabolic diseases in addition to auditory surveillance.

• 한국음향학회지
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• 제24권6호
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• pp.353-357
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• 2005

이과적인 질환이나, 소음에 의한 청력소실이 없는 경우에도 노화에 의한 청력의 변화에 대해서는 잘 알려진 사실이다. 노인들의 청력에 대한보고는 있었지만, 한국인의 노화에 의한 청력변화에 관한 보고는 드물고, 남녀의 차이에 대한 연구는 제한적이며, 아직도 이견이 있다. 최근 조선대학교에서 개발한 청력검사결과 관리 프로그램 (ARCISM)을 이용하여 한국인의 노화성 난청에 대한 기준 청력범위를 구하고자 연구를 시도하였다. 일 년여 동안 대구파티마병원 건강검진센터에 방문한 환자 중 문진에 응한 1603명의 청력검사결과를 소음에 노출된 경우나 기타 이과적인 질환을 배제한 후, 노화에 따른 청력의 변화에 대해 20대에서 80대까지의 청력도를 구하였다. 나이에 의한 주파수 대역별 청력역치의 상승을 통계학적으로 유의하였으며. 고주파수로 갈수록 그 정도가 심하였다. 특히 4kHz와 8kHz에서 남자에 있어서 여자보다 통계적으로 유의하게 청력소실이 더 크게 나타났다. 개발한 프로그램의 운용으로 방대한 청각검사자료를 이용하여 쉽게 노화에 따른 청력 변화에 대해 기준청력범위를 구할 수 있었고, 향후 노화성 난청의 재활이나 한국형 보청기 개발에 기초자료로 활용될 것으로 생각된다.