• Journal of Audiology & Otology
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• v.25 no.2
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• pp.65-71
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• 2021

Background and Objectives: In masking level difference (MLD), the masked detection threshold for a signal is determined as a function of the relative interaural differences between the signal and the masker. Study 1 analyzed the results of school-aged children with good school performance in the MLD test, and study 2 compared their results with those of a group of children with poor academic performance. Subjects and Methods: Study 1 was conducted with 47 school-aged children with good academic performance (GI) and study 2 was carried out with 32 school-aged children with poor academic performance (GII). The inclusion criteria adopted for both studies were hearing thresholds within normal limits in basic audiological evaluation. Study 1 also considered normal performance in the central auditory processing test battery and absence of auditory complaints and/or of attention, language or speech issues. The MLD test was administered with a pure pulsatile tone of 500 Hz, in a binaural mode and intensity of 50 dBSL, using a CD player and audiometer. Results: In study 1, no significant correlation was observed, considering the influence of the variables age and sex in relation to the results obtained in homophase (SoNo), antiphase (SπNo) and MLD threshold conditions. The final mean MLD threshold was 13.66 dB. In study 2, the variables did not influence the test performance either. There was a significant difference between test results in SπNo conditions of the two groups, while no differences were found both in SoNo conditions and the final result of MLD. Conclusions: In study 1, the cut-off criterion of school-aged children in the MLD test was 9.3 dB. The variables (sex and age) did not interfere with the MLD results. In study 2, school performance did not differ in the MLD results. GII group showed inferior results than GI group, only in SπNo condition.

• Korean Journal of Audiology
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• v.25 no.2
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• pp.65-71
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• 2021

Background and Objectives: In masking level difference (MLD), the masked detection threshold for a signal is determined as a function of the relative interaural differences between the signal and the masker. Study 1 analyzed the results of school-aged children with good school performance in the MLD test, and study 2 compared their results with those of a group of children with poor academic performance. Subjects and Methods: Study 1 was conducted with 47 school-aged children with good academic performance (GI) and study 2 was carried out with 32 school-aged children with poor academic performance (GII). The inclusion criteria adopted for both studies were hearing thresholds within normal limits in basic audiological evaluation. Study 1 also considered normal performance in the central auditory processing test battery and absence of auditory complaints and/or of attention, language or speech issues. The MLD test was administered with a pure pulsatile tone of 500 Hz, in a binaural mode and intensity of 50 dBSL, using a CD player and audiometer. Results: In study 1, no significant correlation was observed, considering the influence of the variables age and sex in relation to the results obtained in homophase (SoNo), antiphase (SπNo) and MLD threshold conditions. The final mean MLD threshold was 13.66 dB. In study 2, the variables did not influence the test performance either. There was a significant difference between test results in SπNo conditions of the two groups, while no differences were found both in SoNo conditions and the final result of MLD. Conclusions: In study 1, the cut-off criterion of school-aged children in the MLD test was 9.3 dB. The variables (sex and age) did not interfere with the MLD results. In study 2, school performance did not differ in the MLD results. GII group showed inferior results than GI group, only in SπNo condition.

• Journal of Audiology & Otology
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• v.25 no.3
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• pp.163-170
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• 2021

Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

• Korean Journal of Audiology
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• v.25 no.3
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• pp.163-170
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• 2021

Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.53 no.1
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• pp.19-40
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• 2017

A scientific and objective sound exposure criterion for underwater sound damage on fish has been required since there has been many disputes between an underwater sound maker and a fish damage receiver. The existing criteria are still incomplete scientifically owing to a degree of variability of underwater sounds, diversity of fish hearing sensitivity and damage types, etc. This study reviews existing studies on a hearing mechanism of fish species, manmade underwater sound characteristics and sound exposure assessment parameters, and recent sound exposure criteria. A governing equation for damage coverage estimation and damage coverage dependency on sound source level, ambient noise and transmission loss are also reviewed and interpreted based on sound exposure environments. The foreign and Korean (National Environmental Dispute Medication Commission) criteria are reviewed and compared based on scientific aspects. In addition, the deficit and limit of Korean criteria are presented. The objective of this study is to give a direction for related researches and legislation of sound exposure criteria on fish.

• Journal of Environmental Health Sciences
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• v.34 no.2
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• pp.153-160
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• 2008

Personal noise exposure was assessed in railroad operators working in 40 operation units including the Gyeongbu line, Honam line, and Janghang line between 2004 and 2006. 8-hour TWA were assessed based on the MOL (Ministry of Labor) guideline on noise evaluation, and 17% of these measurements exceeded 85 dBA while 70% were over 80 dBA. When the ACGIH TLV is adopted, 40% of measurements were over TLV (85 dBA). The noise exposure risk of railroad operators was higher for diesel locomotive operation and longer operational distances; in addition, the risk was higher for passenger car operation compared to freight car driving. Given that in Korea, over the past 30 years diesel locomotives have provided most of the railway's motive power and that hearing protective equipment is not likely to be used by workers during operation, railroad operators are at a high risk of noise-induced hearing loss. The result of audiometric test among 568 railroad operators showed that 32.6% of those tested had a hearing threshold shift of more than 40 dB. In conclusion, this study calls for more fundamental measures including noise control countermeasures within the operation areas, development of equipment that generates less noise and adopting limitation on the operation distance for a work shift.

• Korean Journal of Audiology
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• v.25 no.1
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• pp.49-54
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• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of Audiology & Otology
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• v.25 no.1
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• pp.49-54
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• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1301-1307
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• 2006

Purpose : Hearing loss is one of the most common birth defects, and early detection and intervention positively impact language/speech and cognitive development. It has been reported that NICU graduates have a high incidence of hearing loss. So we investigated the incidence, risk factors and clinical outcome of hearing loss in NICU graduates. Methods : This study involved neonatal auditory brainstem response (ABR) testing of newborn infants who graduated from the NICU of Kyungpook National University Hospital during a 3-year period (between July 2002 and June 2005) and subsequent follow-up of these infants. Results : ABR evaluations were performed on 474 infants. Of these infants, 64 showed abnormal ABR (13.5 percent). Of 128 ears from these 64 infants, two ears (1.6 percent) and 10 ears (7.8 percent) were classified as severe and profound hearing loss, respectively. The infants with abnormal ABR had higher incidence of prematurity, low birth weight, very low birth weight, neonatal asphyxia, cranio-facial malformation and amikacin treatment over 15 days (P<0.05). In infants with hyperbilirubinemia, the peak level of serum bilirubin, duration of phototherapy and exchange transfusion were not associated with the higher incidence of hearing loss. Follow-up ABR evaluation was performed on 15 infants with abnormal ABR at $8.8{\pm}4.4months$. In follow-up ABR, 80.0% showed improvement or normalization of threshold sensitivity. Conclusion : NICU graduates exhibit high risk for hearing loss. Systemic and effective hearing assessment program is needed for these high risk infants.

• Journal of Audiology & Otology
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• v.23 no.3
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• pp.153-159
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• 2019

Background and Objectives: We aim to explore the effects of residual auditory steady state response (ASSR) on cochlear implantation (CI) outcomes in children lacking auditory brainstem responses (ABRs). Subjects and Methods: We retrospectively reviewed the data of child CI recipients lacking ABRs. All ears were divided into two groups: with residual ASSR and without ASSR. For each frequency, the T- and C-levels and the electrical dynamic ranges of postoperative 3-month and 1-year mappings were compared between the groups. To evaluate speech perception, patients who received simultaneous bilateral CIs were divided into two groups: group 1 exhibited responses at all frequencies in both ears; in group 2, at least one ear evidenced no response. The Categories of Auditory Perception (CAP) and Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores were compared between the groups. Results: We enrolled 16 patients. At 2 kHz, the postoperative 3-month and 1-year T-levels of patients with residual hearing were lower than those of hearing loss group (p=0.001, p=0.035). In residual hearing group, the ASSR threshold correlated positively with the postoperative 1-year T-level (p=0.012, R²=0.276) and C-level (p=0.002, R²=0.374). Of 10 simultaneous bilateral CI recipients, 5 exhibited ASSRs at all frequencies and the other 5 showed no response at ≥1 frequency. The latter had higher CAP scores at the postoperative 1-year (p=0.018). Conclusions: In children exhibiting hearing loss in ABR testing, residual hearing at 2 kHz ASSR correlated positively with the post-CI T-level. Those with ASSRs at all frequencies had significantly lower CAP scores at the postoperative 1year. CI should not be delayed when marginal residual hearing is evident in ASSR.