Browsing by Subject "hearing loss"

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  • Willberg, Tytti; Sivonen, Ville; Linder, Pia; Dietz, Aarno (2021)
    Background: A large number of different speech-in-noise (SIN) tests are available for testing cochlear implant (CI) recipients, but few studies have compared the different tests in the same patient population to assess how well their results correlate. Methods: A clinically representative group of 80 CI users conducted the Finnish versions of the matrix sentence test, the simplified matrix sentence test, and the digit triplet test. The results were analyzed for correlations between the different tests and for differences among the participants, including age and device modality. Results: Strong and statistically significant correlations were observed between all of the tests. No floor or ceiling effects were observed with any of the tests when using the adaptive test procedure. Age or the length of device use showed no correlation to SIN perception, but bilateral CI users showed slightly better results in comparison to unilateral or bimodal users. Conclusions: Three SIN tests that differ in length and complexity of the test material provided comparable results in a diverse CI user group.
  • Szibor, Annett; Hyvärinen, Petteri; Lehtimäki, Jarmo; Pirvola, Ulla; Ylikoski, Matti; Mäkitie, Antti; Aarnisalo, Antti; Ylikoski, Jukka (2018)
    Conclusion: Music-induced acute acoustic trauma is not inevitably linked to hearing dysfunction as validated by conventional pure tone audiometry. Tinnitus is often in combination with hyperacusis. Our results point at 'silent hearing loss' as the underlying pathology, having afferent nerve terminal damage rather than hair cell loss as the structural correlate. Objectives: Exposure to loud music is one of the most common causes of acute acoustic trauma, which adolescents and teenagers experience by voluntary exposure to loud music of sound levels up to 110 dB(A). Methods: The clinical and psychophysical data of 104 consecutive patients with music-induced hearing disorder (MIHD) were analyzed to construct individual hearing and tinnitus profiles. In all cases, tinnitus was the presenting symptom. Results: Hearing abilities were normal in about two-thirds of the tinnitus patients. Tinnitus was experienced most often as a high-frequency tone (83%). The Tinnitus Handicap Inventory (THI) scores ranged from 0 to 94 with an average score of 43.1. Visual analog scales (VAS) were used to assess tinnitus loudness (average 42.4) and annoyance (average 54.2), and tinnitus awareness was estimated (average 60.3). All VAS values correlated strongly with the THI. Hyperacusis was present in 65% and 71% of the patients reported sleeping disorders.
  • Huhtanen, Miika (Helsingin yliopisto, 2021)
    Lasten kallon murtuminen on harvinainen tapahtuma, joka voi johtaa monenlaisiin komplikaatioihin. Kuulo voi vaurioitua etenkin temporaaliluun murtumassa. Kuuloluiden tai tärykalvon vaurio tai esimerkiksi veri välikorvassa voivat aiheuttaa johtumistyyppistä kuulovikaa, jolla on melko hyvä spontaani paranemistaipumus. Mikäli sisäkorva vaurioituu, voi seurata sensorineuraalinen kuulovika. Tutkimuksessamme selvitimme alle 18-vuotiaiden kallonmurtumapotilaiden korva- ja kuulolöydöksiä. Selvitimme potilaskertomustekstejä läpikäymällä, kuinka yleinen kallonmurtuman komplikaatio kuulovaurio on ja minkä tyyppisiä kuulovikoja potilailla ilmeni. Selvitimme myös eri korvalöydösten esiintyvyyttä, kuten aivo-selkäydinnesteen vuotoa tai verenvuotoa korvasta. Vertasimme kliinisiä löydöksiä radiologisiin murtumalöydöksiin. Tässä 97 potilaan aineistossa kuulovaurio ilmeni vain niillä 51 potilaalla, joilla oli temporaaliluun murtuma. Pysyvä kuulovaurio todettiin kuudella potilaalla, joista kolmella oli OCV-tyyppinen eli sisäkorvan rakenteisiin ulottuva temporaaliluun murtuma. Näillä OCV-murtumapotilailla oli sisäkorvavaurioon sopien sensorineuraalinen tai sekamuotoinen kuulovika. Kuulo oli tutkittu 22 potilaalta, joten on mahdollista, että kaikki kuulovauriot eivät ole tulleet ilmi. Myös kliinisiä korvalöydöksiä oli lähes pelkästään temporaaliluun murtumien yhteydessä. Yleisin korvalöydös oli verenvuoto korvakäytävässä, jota oli 18 potilaalla. Huimaus ja tinnitus ovat tutkimuksemme perusteella harvinainen kallonmurtuman komplikaatio, sillä näitä ilmeni vain muutamilla potilailla ja kaikki tapaukset olivat lieviä eivätkä vaatineet hoitoa. Tutkimuksen perusteella pysyvä kuulovaurio ei ole kovin yleinen komplikaatio lasten kallonmurtuman yhteydessä. Voitaneen kuitenkin tulosten perusteella pitää perusteltuna kuulon tutkimista kertaalleen kaikilta temporaaliluun murtuman saaneilta lapsipotilailta, mutta vasta noin 1-2 kuukauden kuluttua murtumasta, jolloin merkittävä osa väliaikaisista kuulonvajauksista ehtii korjaantua seurannassa.
  • Turunen, Kati (Helsingfors universitet, 2012)
    Objective. Hearing loss is one of the most common chronic health problems, and the number is increasing as a result of population aging. Hearing aids are regarded as the main rehabilitation method for hearing loss. The goal of this follow-up study was to review the experiences of working aged new hearing aid adopters. The focus was to map out the expectations and satisfaction towards the hearing aid, and the disability experiences caused by hearing loss. This thesis is a part of Minna Laakso, Eila Lonka, Johanna Ruusuvuori and Tarja Aaltonen's research project "Communication with Hearing Aid". Also the data was collected as a part of the project. Methods. The population consisted of 42 working age hearing aid first time users (37 64 years). 16 of them were women. Before the hearing aid fitting the participants filled up two self-assessment questionnaires: Denver Scale and Expectations towards hearing aids. Two to three weeks after implementation of the hearing aid the participants filled up the second Denver Scale questionnaire and also IOI-HA questionnaire. Thus it was possible to compare the expectations, disability experiences and satisfaction. The research also studied the construct of Denver scale by using statistical principal component analysis. The model was then utilized in the other statistical analyses. Three participants were also interviewed. Half-structured interviews provided more detailed information about the experiences towards the hearing aid and the hearing loss. The contents of the interviews were then compared to the questionnaire data. Results and conclusions. The expectations towards the hearing aid were high in the study population, although there wasn t any correlation between expectations and short-range satisfaction. Changes in the disability as the result of hearing aid intervention weren t statistically significant. Principal components of the Denver Scale didn't follow the model introduced in previous studies. The contents of the interviews were moderately consistent with the questionnaire data. In this research it was noticed, that the high disabilities due to hearing loss can also be seen after the hearing aid intervention.
  • Sauru, Miro (Helsingin yliopisto, 2020)
    Healthcare in developing countries is still far from Western standards. The shortage of healthcare professionals and the lack of basic hygiene lead to millions of lost lives and life years annually. A person born to a developing country has less both quantitative and qualitative life years to expect. The main objective of health development aid is to improve the availability of medicine and healthcare while reducing mortality and increasing the quality of life. Development aid is an international effort which can be viewed as a moral obligation for industrial countries with high standards of life, but also as pragmatic Realpolitik aiming for higher global political stability. Efficient development aid requires careful planning, perseverance and multidisciplinary collaboration. Inefficiently given aid can lead to increased corruption, inequality and even slower development of the aided country. Different types of hearing loss are the greatest cause of disability globally. Infectious diseases are an exceptionally relevant cause of hearing loss in developing countries. A hearing loss in children can not only lead to problems in learning to read and write, but also to impairment in cognitive abilities, social exclusion and low socio-economic status. World Health Organization estimates six in ten childhood hearing impairments, including their secondary effects, to be preventable. In the following thesis, I will examine different types of health development aid with examples from otorhinolaryngology. I have taken Tanzania under closer examination, as it has been a primary recipient for Finnish development aid in otorhinolaryngology for the past 50 years. Additionally, I will present views about development aid and its future from both Finnish aid workers’ and Tanzanian doctors’ perspectives.
  • Lankinen, Tuuli (Helsingin yliopisto, 2020)
    Our hearing perception is based on the ability to discriminate mechanical sound waves and to amplify and transduce them into electrical stimuli.This function is based on the complex cellular organization of the cochlea, the hearing organ. The sensory epithelium in the organ of Corti spirals along the cochlear duct in a tonotopic arrangement: every sound frequency elicits the strongest response at allocation along this duct. Sound stimulus is detected by three rows of outer hair cells (OHCs) which amplify- and tone-discriminate the sound stimulus, and by one row of inner hair cells (IHCs), which transduce the mechanical stimulus into electric impulses. Basal regions of the cochlea detect high- frequency sounds and apical regions detect low- frequency sounds. The complexity and sensitivity of the cochlea is linked with its vulnerability to various traumas. Most kinds of damage to the mammalian hair cells is irreversible, because these cells are not capable of regeneration. Hearing impairment has many etiologies. Common to them is that damage is permanent and no pharmacotherapy is available. Hearing impairment is often a disabling condition and it has vast societal consequences. The number of hearing impaired people is constantly increasing and the WHO has estimated that 10% of the world`s population will suffer from disabling hearing loss in 2050. Mesencephalic astrocyte- derived neurotrophic factor (MANF) is an unconventional, ER-resident protein that promotes ER- homeostasis. It has been associated with cytoprotective functions in many neurodegenerative disease- models and shown to promote recovery after ischemic trauma. MANF expression has been previously found in many cell-types in the cochlea, including OHCs and IHCs. Its deficiency in a mouse model led to upregulation of ER-stress markers and a robust, tonotopic base –to apex gradient loss of outer hair cells and severe hearing loss. This study examines the role of MANF in noise-induced trauma in the hair cells of the cochlea. In a conditionally inactivated (Manf -/- cKO) mouse model in the C57BL/6J – background, where Manf has been inactivated from most of the cochlear cells, I studied, if Manf -deficiency sensitizes the cells to noise-induced cell death in two age-groups. I also examined the basic and noise- induced MANF expression, using two mouse- strains, C57BL/6J and CBA/Ca. I also examined OHC stereociliary bundle morphology to find out if noise induces morphological changes in Manf cKO-mice that differ from noise-exposed C57BL/6j wild type mice. This study found that OHCs have a low MANF- expression, whereas in IHCs the expression is strong. MANF is expressed in a base- to apex gradient in the OHCs of the two mouse-strains examined, in a uniform pattern, that correlates with vulnerability, implicating that low levels of MANF predispose basal OHCs to vulnerability. MANF expression in the IHCs was non-gradiental. Noise did not induce upregulation, as was expected, but instead noise induced downregulation of MANF in the basal region of the OHCs by an unknown mechanism in both mouse-strains.This suggests that noise-induced trauma induces ER dyshomeostasis, possibly independent of ER stress response pathways ,unfold protein response (UPR). This study also demonstrates that MANF deficiency sensitizes the OHCs to noise- induced trauma, resulting in more elevated OHC loss and hearing thresholds. This sensitization is mainly caused by a progressive degenerative changes seen in the OHC stereociliary bundles of Manf cKO-mice, and is associated with more severe noise-induced hearing loss. The results of my study suggest that MANF has an important, yet unknown, protective role in noise-induced trauma in OHCs. These results support the possible role of MANF as a therapeutic agent in a noise-induced trauma.
  • Laakso, Minna; Salmenlinna, Inkeri; Aaltonen, Tarja; Koskela, Inka; Ruusuvuori, Johanna (2019)
    Background To manage conversational breakdowns, individuals with hearing loss (HL) often have to request their interlocutors to repeat or clarify. Aims To examine how middle-aged hearing aid (HA) users manage conversational breakdowns by using open-class repair initiations (e.g., questions such as sorry, what and huh), and whether their use of repair initiations differs from their normally hearing interlocutors. Methods & Procedures Eighteen 45-64-year-old adults with acquired mild to moderate HL participated in the study. The participants were videotaped in everyday interactions at their homes and workplaces and in clinical encounters with hearing health professionals. Interactions were transcribed and open-class repair initiations of participants with HL and their interlocutors were identified using conversation analysis. The frequencies of initiations were analyzed statistically between the groups, and the contexts and structure of repair sequences dealing with communication breakdown were analyzed. Outcomes & Results Before acquiring HA the participants with HL reported intense use of open-class repair initiation. After HAs were acquired, there was no statistically significant difference in the frequency of open-class repair initiations between HA users and their interlocutors. The most common means for open-class repair initiation in the data was interrogative word mita ('what'). Vocalization ha ('huh'), apologetic expression anteeksi ('sorry') and clausal initiations (e.g., 'what did you say'/'I didn't hear') occurred less often. Open-class repair initiations emerged in contexts where they typically occur in conversation, such as topical shifts, overlapping talk and action, background noise, and disagreements. When used, open-class repair initiations most often led to repetition by the interlocutor, which immediately repaired the conversational breakdown. Long clarification sequences with multiple repair initiations did not occur. Conclusions & Implications Participants with mild to moderate HL using hearing amplification initiate open-class repair similarly to their normally hearing conversational partners when the frequency, types, contexts and structure of repair are considered. The findings diminish the stigma related to HL, HAs and the use of open-class repair. The findings suggest that HA amplifies hearing successfully in everyday conversation when the level of HL is mild to moderate. However, the evidence for the benefit of HAs remains indirect.
  • Iivanainen, Vilma (Helsingin yliopisto, 2021)
    Recent studies have associated ER stress with various types of hearing loss, such as drug- and noise-induced, age-related, and hereditary hearing loss. However, the research has mostly focused on auditory sensory cell (hair cell) death, and it is not well understood if other molecular mechanisms can drive ER stress-dependent hearing loss. We used Manfflox/flox;Pax2-Cre conditional knockout (cKO) mice under the C57BL/6J (B6) mouse strain to study the effects of genetically-induced chronic ER stress on hearing function. In these mice, the gene coding for mesencephalic astrocyte-derived neurotrophic factor (Manf) has been silenced specifically in the cochlea. Manf is thought to act as an ER homeostasis regulator, and it has shown cytoprotective properties in different disease models both in vitro and in vivo. However, Manf’s mode of action is still poorly understood and even less is known about its function in the inner ear. Previously, cKO mice were found to upregulate ER stress markers in the cochlear hair cells. These mice develop progressive high-frequency hearing loss characterized by high-frequency outer hair cell (OHC) death. However, they have elevated hearing thresholds already at postnatal day 22 (P22) before any OHC death takes place and have elevated hearing thresholds in hearing frequencies where OHCs are retained. Therefore, there has to be another pathological mechanism besides OHC death accounting for the elevations in their hearing thresholds. Hence, we wanted to study the effect of ER stress on the outer hair cell hair bundle structure. The hair bundle is located at the apical pole of the hair cells, and it consists of filamentous actin (F-actin)-filled stereocilia. In mechanotransduction (MET), sound stimuli-induced motions of cochlear fluids cause stereocilia to deflect towards the tallest stereocilia row, allowing for depolarization of hair cells and transformation of mechanical force into electrical signal. Therefore, hair bundle is an essential structure for the hearing function. We used scanning electron microscopy (SEM) and fluorescent microscopy to study OHC hair bundles of cKO mice. We saw disorganization of the bundle structure already at P22. It progressed with age and advanced to strong stereocilia fusion by P56. At this age, all of the high-frequency OHCs of cKO mice displayed stereocilia fusion. We used cochlear whole mounts and immunostainings to study the protein composition of OHC stereocilia of Manf-deficient mice. The base of the stereocilia, termed as the tapering region, contains proteins that link the plasma membrane of stereocilia to their F-actin core, ensuring the cohesion of individual stereocilia. Mutations in these proteins have been associated with stereocilia fusion and hair bundle disorganization. At P56, we saw that stereocilia tapering region proteins radixin (RDX) and myosin 6 (Myo6) were mislocalized from the tapering region towards the apical tips of stereocilia in the high-frequency OHCs of cKO mice. Additionally, we saw that PTPRQ – a tapering region protein that is under normal conditions expressed only in the IHCs of mature cochlea – was upregulated in OHCs of cKO mice, yielding an expression pattern similar to RDX and Myo6. In addition, we used the F-actin probe phalloidin to quantitatively compare F-actin densities in the cuticular plates of cKO and WT mice. Cuticular plate is a structure responsible for attaching stereocilia to hair cell body. It consists of a dense F-actin network and prior studies have associated defects in the cuticular plate composition with hearing loss and stereocilia bundle abnormalities. We found a significant decrease in phalloidin staining intensity in the cuticular plates of high-frequency OHCs of cKO mice, indicating that their cuticular plate F-actin rigidity had been reduced. Together our data shows that Manf deficiency promotes diverse impairments in the OHC hair bundles, consequently inducing hearing loss. To conclude, our study presents novel insights into the complexity of ER stress-induced cochlear pathology. We show that ER stress impairs MET by inducing structural changes in the OHC hair bundle. It appears to be the major reason for hearing loss in the cKO mice, rather than hair cell death. In the future, the impact of Manf deficiency to the inner ear should be further studied. For example, younger and aged cKO mice could be studied to better characterize the progression of Manf deficiency-induced cochlear pathology and hearing loss. Similarly, Manf’s effect on hearing should be studied in other ER stress models to determine its role in the hearing function.
  • Looi, Valerie; Torppa, Ritva; Prvan, Tania; Vickers, Debi (2019)
    The primary aim of this current study was to compare the role, importance and value placed on music by families with normally hearing (NH) children, to those who had a child with a hearing loss (HL) who wore either hearing aids and/or cochlear implants. A secondary aim was to see whether this differed between the countries. Parents of children aged 2–6 years living in Australia, Finland, and the United Kingdom were invited to complete the Role of Music in Families Questionnaire (RMFQ). Two groups of participants were recruited from each country: (i) parents of NH children, and (ii) parents of children with a HL. The RMFQ had seven subsections covering topics such as music participation, attitudes to music, importance of music in the family, and future perspectives on music. Three hundred and twenty-two families of NH children, and 56 families of children with HL completed the questionnaire (Australia: 50 NH, 25 HL; Finland: 242 NH, 21 HL; United Kingdom: 30 NH, 10 HL). Analyses compared between NH and HL groups within each country, and between the three countries for the NH group, and the HL group, independently. Overall, there were few significant differences between the participation levels, role, or importance of music in families with NH children compared to those with a child who had a HL, regardless of whether the families lived in Australia, Finland or the United Kingdom. Children first started to respond to music at similar ages, and overall music participation frequency, and music enjoyment were relatively similar. The importance of music in the family was also similar between the NH and HL groups. In comparing between the countries, Finnish children had a tendency to have higher participation rates in musical activities, with few other differences noted. Overall, the results of this study indicate that children, regardless of hearing levels or country of residence, have similar levels of music engagement and enjoyment, and HL is not seen as a contraindication to music participation and involvement by the parents involved in this study.
  • Keski-Säntti, Noora (Helsingin yliopisto, 2020)
    Tavoitteet. Tutkielman tarkoituksena oli selvittää akuutteihin, osastohoitoa vaatineisiin välikorva- tai kartiolisäketulehduksiin liittyvien kuulonalenemien vaikeusastetta ja ennustetta. Erityisesti mielenkiinto kohdistui sensorineuraaliseen kuulonalenemaan sekä eroavaisuuksiin eri taudinaiheuttajaryhmien välillä. Menetelmät. Tutkimusta varten läpikäytiin retrospektiivisesti HYKS:n Korva-, nenä- ja kurkkutautien osastolla KO6 vuosina 2013-2018 akuutin välikorva- tai kartiolisäketulehduksen vuoksi hoidossa olleiden potilaiden potilastiedot ja seuranta-ajan kuulontutkimukset. Tutkimukseen valikoitui 94 potilasta, jotka jaettiin kolmeen taudinaiheuttajaryhmään: streptokokki A -, (38 potilasta), pneumokokki -, (11 potilasta) ja muut/ei kasvua -ryhmä (45 potilasta). Ryhmiin kuuluvien potilaiden hoitojaksoon liittyviä ensimmäisiä sekä viimeisiä kuulontutkimuksia sekä näistä luotuja potilaan parasta kuuloa kuvaavia ns. minimiarvoja tarkasteltiin ja ryhmien tuloksia vertailtiin keskenään. Tulokset ja johtopäätökset. Puhetaajuuksilla (500-4000 Hz) esiintyi kaikissa taudinaiheuttajaryhmissä sensorineuraalista kuulonalenemaa, joka palautui seurannan aikana lähes täysin lukuun ottamatta pneumokokkiryhmää. Puhetaajuuksilla seurannan lopussa normaalituloksen kuulontutkimuksessa sai 79% potilaista streptokokki A -ryhmässä, 56 % pneumokokkiryhmässä ja 74% muut/ei kasvua -ryhmässä. Keskeisten puhetaajuuksien keskiarvot (PTA) palautuivat normaalitasolle vain streptokokki A -ryhmässä. Heikoimmat tulokset sekä ilmajohto- ja minimikynnyksissä että PTA-arvoissa olivat pneumokokkiryhmässä, mutta huomioiden ryhmän pienen koon, ei eri taudinaiheuttajaryhmien välillä havaittu tilastollisesti merkitseviä eroja. Tutkimuksen perusteella suurella osalla sairaalahoitoa vaatineeseen akuuttiin välikorva- tai kartiolisäketulehdukseen liittyy sensorineuraalista kuulonalenemaa, joka kuitenkin nykyisillä hoitoperiaatteilla on suurimmalla osalla potilaista joko täysin tai osittain palautuvaa taudinaiheuttajasta riippumatta. (198 sanaa)