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Hearing Disorders: HELP
Articles by Wouter Albert Dreschler
Based on 53 articles published since 2009
(Why 53 articles?)
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Between 2009 and 2019, W. Dreschler wrote the following 53 articles about Hearing Disorders.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Interventions to prevent occupational noise-induced hearing loss. 2017

Tikka, Christina / Verbeek, Jos H / Kateman, Erik / Morata, Thais C / Dreschler, Wouter A / Ferrite, Silvia. ·Cochrane Work Review Group, Finnish Institute of Occupational Health, PO Box 310, Kuopio, Finland, 70101. ·Cochrane Database Syst Rev · Pubmed #28685503.

ABSTRACT: BACKGROUND: This is the second update of a Cochrane Review originally published in 2009. Millions of workers worldwide are exposed to noise levels that increase their risk of hearing disorders. There is uncertainty about the effectiveness of hearing loss prevention interventions. OBJECTIVES: To assess the effectiveness of non-pharmaceutical interventions for preventing occupational noise exposure or occupational hearing loss compared to no intervention or alternative interventions. SEARCH METHODS: We searched the CENTRAL; PubMed; Embase; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; and OSH UPDATE to 3 October 2016. SELECTION CRITERIA: We included randomised controlled trials (RCT), controlled before-after studies (CBA) and interrupted time-series (ITS) of non-clinical interventions under field conditions among workers to prevent or reduce noise exposure and hearing loss. We also collected uncontrolled case studies of engineering controls about the effect on noise exposure. DATA COLLECTION AND ANALYSIS: Two authors independently assessed study eligibility and risk of bias and extracted data. We categorised interventions as engineering controls, administrative controls, personal hearing protection devices, and hearing surveillance. MAIN RESULTS: We included 29 studies. One study evaluated legislation to reduce noise exposure in a 12-year time-series analysis but there were no controlled studies on engineering controls for noise exposure. Eleven studies with 3725 participants evaluated effects of personal hearing protection devices and 17 studies with 84,028 participants evaluated effects of hearing loss prevention programmes (HLPPs). Effects on noise exposure Engineering interventions following legislationOne ITS study found that new legislation in the mining industry reduced the median personal noise exposure dose in underground coal mining by 27.7 percentage points (95% confidence interval (CI) -36.1 to -19.3 percentage points) immediately after the implementation of stricter legislation. This roughly translates to a 4.5 dB(A) decrease in noise level. The intervention was associated with a favourable but statistically non-significant downward trend in time of the noise dose of -2.1 percentage points per year (95% CI -4.9 to 0.7, 4 year follow-up, very low-quality evidence). Engineering intervention case studiesWe found 12 studies that described 107 uncontrolled case studies of immediate reductions in noise levels of machinery ranging from 11.1 to 19.7 dB(A) as a result of purchasing new equipment, segregating noise sources or installing panels or curtains around sources. However, the studies lacked long-term follow-up and dose measurements of workers, and we did not use these studies for our conclusions. Hearing protection devicesIn general hearing protection devices reduced noise exposure on average by about 20 dB(A) in one RCT and three CBAs (57 participants, low-quality evidence). Two RCTs showed that, with instructions for insertion, the attenuation of noise by earplugs was 8.59 dB better (95% CI 6.92 dB to 10.25 dB) compared to no instruction (2 RCTs, 140 participants, moderate-quality evidence). Administrative controls: information and noise exposure feedbackOn-site training sessions did not have an effect on personal noise-exposure levels compared to information only in one cluster-RCT after four months' follow-up (mean difference (MD) 0.14 dB; 95% CI -2.66 to 2.38). Another arm of the same study found that personal noise exposure information had no effect on noise levels (MD 0.30 dB(A), 95% CI -2.31 to 2.91) compared to no such information (176 participants, low-quality evidence). Effects on hearing loss Hearing protection devicesIn two studies the authors compared the effect of different devices on temporary threshold shifts at short-term follow-up but reported insufficient data for analysis. In two CBA studies the authors found no difference in hearing loss from noise exposure above 89 dB(A) between muffs and earplugs at long-term follow-up (OR 0.8, 95% CI 0.63 to 1.03 ), very low-quality evidence). Authors of another CBA study found that wearing hearing protection more often resulted in less hearing loss at very long-term follow-up (very low-quality evidence). Combination of interventions: hearing loss prevention programmesOne cluster-RCT found no difference in hearing loss at three- or 16-year follow-up between an intensive HLPP for agricultural students and audiometry only. One CBA study found no reduction of the rate of hearing loss (MD -0.82 dB per year (95% CI -1.86 to 0.22) for a HLPP that provided regular personal noise exposure information compared to a programme without this information.There was very-low-quality evidence in four very long-term studies, that better use of hearing protection devices as part of a HLPP decreased the risk of hearing loss compared to less well used hearing protection in HLPPs (OR 0.40, 95% CI 0.23 to 0.69). Other aspects of the HLPP such as training and education of workers or engineering controls did not show a similar effect.In three long-term CBA studies, workers in a HLPP had a statistically non-significant 1.8 dB (95% CI -0.6 to 4.2) greater hearing loss at 4 kHz than non-exposed workers and the confidence interval includes the 4.2 dB which is the level of hearing loss resulting from 5 years of exposure to 85 dB(A). In addition, of three other CBA studies that could not be included in the meta-analysis, two showed an increased risk of hearing loss in spite of the protection of a HLPP compared to non-exposed workers and one CBA did not. AUTHORS' CONCLUSIONS: There is very low-quality evidence that implementation of stricter legislation can reduce noise levels in workplaces. Controlled studies of other engineering control interventions in the field have not been conducted. There is moderate-quality evidence that training of proper insertion of earplugs significantly reduces noise exposure at short-term follow-up but long-term follow-up is still needed.There is very low-quality evidence that the better use of hearing protection devices as part of HLPPs reduces the risk of hearing loss, whereas for other programme components of HLPPs we did not find such an effect. The absence of conclusive evidence should not be interpreted as evidence of lack of effectiveness. Rather, it means that further research is very likely to have an important impact.

2 Review Sensorineural hearing loss in patients with head and neck cancer after chemoradiotherapy and radiotherapy: a systematic review of the literature. 2015

Theunissen, Eleonoor A R / Bosma, Sophie C J / Zuur, Charlotte L / Spijker, René / van der Baan, Sieberen / Dreschler, Wouter A / de Boer, Jan Paul / Balm, Alfons J M / Rasch, Coen R N. ·Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands. ·Head Neck · Pubmed #24478269.

ABSTRACT: BACKGROUND: Both radiotherapy (RT) and cisplatin-based chemoradiotherapy (CRT) in patients with head and neck cancer may cause sensorineural hearing loss (SNHL). The purpose of this review was to provide more insight into SNHL because of CRT compared to RT. METHODS: Comprehensive search of Medline and Embase with the terms "radiotherapy" combined with "ototoxicity," "head and neck squamous cell carcinoma," and synonyms. RESULTS: Of the 2507 studies found, 21 were included in this study. Pooled analysis could not be committed because of heterogeneity. Incidence rates of SNHL after RT and CRT varied considerably, with percentages ranging from 0% to 43% and 17% to 88%, respectively. Factors that influenced the risk of SNHL were radiation dose to the cochlea, follow-up time, age, baseline hearing level, and cisplatin dose. CONCLUSION: The wide range of SNHL incidence rates makes it impossible to draw any conclusions on the severity of RT- and CRT-induced ototoxicity. To allow for future comparison of study outcomes, development of uniform criteria is of utmost importance.

3 Review Interventions to prevent occupational noise-induced hearing loss: a Cochrane systematic review. 2014

Verbeek, Jos H / Kateman, Erik / Morata, Thais C / Dreschler, Wouter A / Mischke, Christina. ·* Cochrane Occupational Safety and Health Review Group, Finnish Institute of Occupational Health , Kuopio , Finland. ·Int J Audiol · Pubmed #24564697.

ABSTRACT: OBJECTIVE: To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions. DESIGN: We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and interrupted time-series of hearing loss prevention among workers exposed to noise. STUDY SAMPLE: We included 19 studies with 82 794 participants evaluating effects of hearing loss prevention programs (HLPP). The overall quality of studies was low to very low, as rated using the GRADE approach. RESULTS: One study of stricter legislation showed a favorable effect on noise levels. Three studies, of which two RCTs, did not find an effect of a HLPP. Four studies showed that better use of hearing protection devices in HLPPs decreased the risk of hearing loss. In four other studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz (95% CI - 0.5 to 1.7) than non-exposed workers. In two similar studies there was a substantial risk of hearing loss in spite of a HLPP. CONCLUSIONS: Stricter enforcement of legislation and better implementation of HLPPs can reduce noise levels in workplaces. Better evaluations of technical interventions and long-term effects are needed.

4 Review The effectiveness of bilateral cochlear implants for severe-to-profound deafness in adults: a systematic review. 2013

van Schoonhoven, Jelmer / Sparreboom, Marloes / van Zanten, Bert G A / Scholten, Rob J P M / Mylanus, Emmanuel A M / Dreschler, Wouter A / Grolman, Wilko / Maat, Bert. ·Department of Clinical and Experimental Audiology, Academic Medical Center, Amsterdam, The Netherlands. jvanschoonhoven@amc.nl ·Otol Neurotol · Pubmed #23444466.

ABSTRACT: OBJECTIVE: Assessment of the clinical effectiveness of bilateral cochlear implantation compared with unilateral cochlear implantation or bimodal stimulation, in adults with severe-to-profound hearing loss. In 2007, the National Institute for Health and Clinical Excellence (NICE) in the U.K. conducted a systematic review on cochlear implantation. This study forms an update of the adult part of the NICE review. DATA SOURCES: The electronic databases MEDLINE and Embase were searched for English language studies published between October 2006 and March 2011. STUDY SELECTION: Studies were included that compared bilateral cochlear implantation with unilateral cochlear implantation and/or with bimodal stimulation, in adults with severe-to-profound sensorineural hearing loss. Speech perception in quiet and in noise, sound localization and lateralization, speech production, health-related quality of life, and functional outcomes were analyzed. DATA EXTRACTION: Data extraction forms were used to describe study characteristics and the level of evidence. DATA SYNTHESIS: The effect size was calculated to compare different outcome measures. CONCLUSION: Pooling of data was not possible because of the heterogeneity of the studies. As in the NICE review, the level of evidence of the included studies was low, although some of the additional studies showed less risk of bias. All studies showed a significant bilateral benefit in localization over unilateral cochlear implantation. Bilateral cochlear implants were beneficial for speech perception in noise under certain conditions and several self-reported measures. Most speech perception in quiet outcomes did not show a bilateral benefit. The current review provides additional evidence in favor of bilateral cochlear implantation, even in complex listening situations.

5 Review Interventions to prevent occupational noise-induced hearing loss. 2012

Verbeek, Jos H / Kateman, Erik / Morata, Thais C / Dreschler, Wouter A / Mischke, Christina. ·Cochrane Occupational Safety and Health Review Group, Finnish Institute of Occupational Health, Kuopio, Finland.jos.verbeek@ttl.fi. ·Cochrane Database Syst Rev · Pubmed #23076923.

ABSTRACT: BACKGROUND: Millions of workers worldwide are exposed to noise levels that increase their risk of hearing impairment. Little is known about the effectiveness of hearing loss prevention interventions. OBJECTIVES: To assess the effectiveness of non-pharmaceutical interventions for preventing occupational noise exposure or occupational hearing loss compared to no intervention or alternative interventions. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; and OSH update to 25 January 2012. SELECTION CRITERIA: We included randomised controlled trials (RCT), controlled before-after studies (CBA) and interrupted time-series (ITS) of non-clinical hearing loss prevention interventions under field conditions among workers exposed to noise. DATA COLLECTION AND ANALYSIS: Two authors independently assessed study eligibility and risk of bias and extracted data. MAIN RESULTS: We included 25 studies. We found no controlled studies on engineering controls for noise exposure but one study evaluated legislation to reduce noise exposure in a 12-year time-series analysis. Eight studies with 3,430 participants evaluated immediate and long-term effects of personal hearing protection devices (HPDs) and sixteen studies with 82,794 participants evaluated short and long-term effects of hearing loss prevention programmes (HLPPs). The overall quality of studies was low to very low.The one ITS study that evaluated the effect of new legislation in reducing noise exposure found that the median noise level decreased by 27.7 dB(A) (95% confidence interval (CI) -36.1 to -19.3 dB) immediately after the implementation of stricter legislation and that this was associated with a favourable downward trend in time of -2.1 dB per year (95% CI -4.9 to 0.7).Hearing protection devices attenuated noise with about 20 dB(A) with variation among brands and types but for ear plugs these findings depended almost completely on proper instruction of insertion. Noise attenuation ratings of hearing protection under field conditions were consistently lower than the ratings provided by the manufacturers.One cluster-RCT compared a three-year information campaign as part of a hearing loss prevention programme for agricultural students to audiometry only with three and 16-year follow-up but there were no significant differences in hearing loss. Another study compared a HLPP, which provided regular personal noise exposure information, to a programme without this information in a CBA design. Exposure information was associated with a favourable but non-significant reduction of the rate of hearing loss of -0.82 dB per year (95% CI -1.86 to 0.22). Another cluster-RCT evaluated the effect of extensive on-site training sessions and the use of personal noise-level indicators versus information only on noise levels but did not find a significant difference after four months follow-up (Mean Difference (MD) -0.30 dB(A) (95%CI -3.95 to 3.35).There was very low quality evidence in four very long-term studies, that better use of HPDs as part of a HLPP decreased the risk of hearing loss compared to less well used hearing protection in HLPPs. Other aspects of the HLPP such as training and education of workers or engineering controls did not show a similar effect.In four long-term studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz than workers that were not exposed to noise (95% CI -0.5 to 1.7) which is about the level of hearing loss caused by exposure to 85 dB(A). In addition, two other studies showed substantial risk of hearing loss in spite of the protection of a HLPP compared to non-exposed workers. AUTHORS' CONCLUSIONS: There is low quality evidence that implementation of stricter legislation can reduce noise levels in workplaces. Even though case studies show that substantial reductions in noise levels in the workplace can be achieved, there are no controlled studies of the effectiveness of such measures. The effectiveness of hearing protection devices depends on training and their proper use. There is very low quality evidence that the better use of hearing protection devices as part of HLPPs reduces the risk of hearing loss, whereas for other programme components of HLPPs we did not find such an effect. Better implementation and reinforcement of HLPPs is needed. Better evaluations of technical interventions and long-term effects are needed.

6 Review Interventions to prevent occupational noise induced hearing loss. 2009

Verbeek, Jos H / Kateman, Erik / Morata, Thais C / Dreschler, Wout / Sorgdrager, Bas. ·Finnish Institute of Occupational Health, Center of Expertise for Good Practices and Competence, Team of Knowledge Transfer in Occupational Health and Safety, Cochrane Occupational Health Field, PO Box 93 (Neulaniementie 4), Kuopio, Finland, 70701. ·Cochrane Database Syst Rev · Pubmed #19588388.

ABSTRACT: BACKGROUND: Millions of workers worldwide are exposed to noise levels that increase their risk of hearing impairment. Little is known about the effectiveness of hearing loss prevention interventions. OBJECTIVES: To assess the effectiveness of non-pharmaceutical interventions for preventing occupational noise exposure or occupational hearing loss compared to no intervention or alternative interventions. SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 4, 2008); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; NIOSHTIC, CISDOC and mRCT to 15 December 2008. SELECTION CRITERIA: Randomised controlled trials, controlled before-after studies and interrupted time series (ITS) of non-clinical hearing loss prevention interventions under field conditions among workers exposed to noise. DATA COLLECTION AND ANALYSIS: Two authors (EK, JV) independently assessed study eligibility and trial quality and extracted data. MAIN RESULTS: Twenty-one studies were included. One study evaluated a strategy to reduce noise exposure. Fourteen studies with 75,672 participants evaluated hearing loss prevention programmes (HLPPs), and six studies with 169 participants evaluated hearing protection. The overall quality of studies was low.One ITS study evaluated the effect of new legislation in reducing noise exposure. It found that the median noise level decreased by 27.7 dB(A) (95% confidence interval (CI) -36.1 to -19.3 dB) with a change in trend in time of -2.1 dB per year (95% CI -4.9 to 0.7).A hearing protection study in army recruits compared those exposed to impulse noise with non-exposed recruits. The odds ratio (OR) for hearing loss was 3.0 (95% CI 1.1 to 8.0) despite hearing protection. In four studies, workers in a HLPP had a 0.5 dB HL greater hearing loss at 4 kHz than non-noise exposed workers (95% CI -0.5 to 1.7). In one study, the hazard ratio of hearing loss was 3.8 (95% CI 2.7 to 5.3) for workers exposed to noise compared to non-exposed workers.In three studies, a high quality HLPP had a lower risk of hearing loss than lower quality programmes.Noise attenuation ratings of hearing protection under field conditions were consistently lower than the ratings provided by the manufacturers. AUTHORS' CONCLUSIONS: There is low quality evidence that legislation can reduce noise levels in workplaces.The effectiveness of hearing protection devices depends on their proper use. There is contradictory evidence that HLPPs are effective in the long-term. Even though case studies show that substantial reductions can be achieved, there is no evidence that this is realised in practice. Better implementation and reinforcement is needed.Better evaluations of technical interventions and long-term effects are needed. Audiometric and noise measurement data are potentially valuable for such studies.

7 Article Potential Consequences of Spectral and Binaural Loudness Summation for Bilateral Hearing Aid Fitting. 2018

van Beurden, Maarten / Boymans, Monique / van Geleuken, Mirjam / Oetting, Dirk / Kollmeier, Birger / Dreschler, Wouter A. ·1 Department of Clinical and Experimental Audiology, Amsterdam UMC, Amsterdam, the Netherlands. · 2 Libra Rehabilitation and Audiology, Eindhoven, the Netherlands. · 3 HörTech gGmbH, Oldenburg, Germany. · 4 Cluster of Excellence Hearing4all, Oldenburg, Germany. · 5 Medizinische Physik, Universität Oldenburg, Oldenburg, Germany. ·Trends Hear · Pubmed #30353784.

ABSTRACT: Aversiveness of loud sounds is a frequent complaint by hearing aid users, especially when fitted bilaterally. This study investigates whether loudness summation can be held responsible for this finding. Two aspects of loudness summation should be taken into account: spectral loudness summation for broadband signals and binaural loudness summation for signals that are presented binaurally. In this study, the effect of different symmetrical hearing losses was studied. Measurements were obtained with the widely used technique of Adaptive Categorical Loudness Scaling. For large bandwidths, spectral loudness summation for hearing-impaired listeners was found to be greater than that for normal-hearing listeners, both for monaurally and binaurally presented signals. For binaural loudness summation, the effect of hearing loss was not significant. In all cases, individual differences were substantial.

8 Article Ocular albinism with infertility and late-onset sensorineural hearing loss. 2018

Fabian-Jessing, Bjørn K / Vestergaard, Else Marie / Plomp, Astrid S / Bergen, Arthur A / Dreschler, Wouter A / Duno, Morten / Winiarska, Beata S / Neumann, Linda / Gaihede, Michael / Vorum, Henrik / Petersen, Michael B. ·Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark. · Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. · Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark. · Department of Clinical Genetics, Academic Medical Center, Amsterdam, The Netherlands. · Department of Otorhinolaryngology Head and Neck Surgery, Academic Medical Center, Amsterdam, The Netherlands. · Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. · Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark. · Department of Otolaryngology, Head and Neck Surgery, Aalborg University Hospital, Aalborg, Denmark. ·Am J Med Genet A · Pubmed #30160833.

ABSTRACT: Ocular albinism type 1 (OA1) is caused by mutations in the GPR143 gene located at Xp22.2. The manifestations, which are due to hypopigmentation, are confined to the eyes and optic pathway. OA1 associated with late-onset sensorineural hearing loss was previously reported in a single family and hypothesized to be caused by a contiguous gene deletion syndrome involving GPR143 and the adjacent gene, TBL1X. Here, we report on a family with OA1, infertility, late-onset sensorineural hearing loss, and a small interstitial Xp microdeletion including the GPR143, TBL1X, and SHROOM2 genes. In addition, we re-examined a patient previously described with OA1, infertility and a similar Xp deletion with audiologic follow-up showing a late-onset sensorineural hearing loss. Our results raise an intriguing question about the possibility for TBL1X (absence) involvement in this type of hearing loss. However, our study cannot claim a causative relationship and more convincing evidence is needed before the hypothesis can be accepted that TBL1X could be involved in late-onset sensorineural hearing loss and that ocular albinism with late-onset sensorineural hearing loss can present itself as a contiguous gene deletion/microdeletion syndrome. The finding of infertility in all affected male patients demonstrates that this deletion, including the SHROOM2 gene, may be a potentially causative X-linked genetic factor of male infertility.

9 Article Evaluation of Auditory Functioning and Rehabilitation Using Patient-Reported Outcome Measures. 2018

Lansbergen, Simon / De Ronde-Brons, Inge / Boymans, Monique / Soede, Wim / Dreschler, Wouter A. ·1 Clinical and Experimental Audiology, Academic Medical Centre, Amsterdam, The Netherlands. · 2 Department of Audiology, Leiden University Medical Centre, Leiden, The Netherlands. ·Trends Hear · Pubmed #30047308.

ABSTRACT: There is lack of a systematic approach concerning how to select an adequate hearing aid and how to evaluate its efficacy with respect to the personal needs of rehabilitation. The goal of this study was to examine the applicability and added value of two widely used self-reporting questionnaires in relation to the evaluation of hearing aid fitting. We analyzed responses, pre- and postfitting, from 1,319 subjects who completed the Client Oriented Scale of Improvement (COSI) and a slightly adapted version of the Amsterdam Inventory for Auditory Disability and Handicap (in Dutch: AVAB). Most COSI responses were at or near the maximum possible score. Results show a close relation between COSI's degree of change and final ability (Spearman's rho = 0.71). Both AVAB and COSI showed a significant effect of hearing aid experience, but-in contrast to AVAB-COSI did not show a significant effect of the degree of hearing loss. In addition, a Friedman test showed significant differences between six dimensions of auditory functioning for both AVAB and COSI, although post hoc analysis revealed that for COSI, the dimension speech in quiet explained most variation between dimensions. In conclusion, the effects of hearing loss were more salient in AVAB, while both AVAB and COSI showed differences regarding hearing aid experience. Combining the advantages of both methods results in a detailed evaluation of hearing aid rehabilitation. Our results therefore suggest that both methods should be used in a complementary manner, rather than separately.

10 Article Accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss: incorporating automatic conditional rescreening. 2018

Sheikh Rashid, Marya / Dreschler, Wouter A. ·Department of Clinical and Experimental Audiology, ENT Department, Academic Medical Center (AMC), Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.adlunisr@gmail.com. · Department of Clinical and Experimental Audiology, ENT Department, Academic Medical Center (AMC), Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. ·Int Arch Occup Environ Health · Pubmed #29959525.

ABSTRACT: PURPOSE: To validate the accuracy of an internet-based speech-in-noise hearing screening test for high-frequency hearing loss (HFHL) 'Occupational Earcheck (OEC)' incorporating an automatic conditional rescreening, in an occupationally noise-exposed population. Secondary objectives were to assess the effects of age on test accuracy measures, and to assess the test accuracy for different degrees of HFHL. METHODS: A study was conducted on cross-sectional data of occupational audiometric examinations, including the index test OEC and reference standard pure-tone air conduction audiometry, of 80 noise-exposed workers. Sensitivity, specificity, and likelihood ratios were calculated for the OEC, after automatic conditional rescreening, for a younger and an older age group, and for two degrees of HFHL (HFHL RESULTS: Test specificity for HFHL CONCLUSIONS: The OEC is an appropriate screening test, especially for HFHL

11 Article Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability. 2018

Soli, Sigfrid D / Amano-Kusumoto, Akiko / Clavier, Odile / Wilbur, Jed / Casto, Kristen / Freed, Daniel / Laroche, Chantal / Vaillancourt, Véronique / Giguère, Christian / Dreschler, Wouter A / Rhebergen, Koenraad S. ·a House Clinic , Los Angeles , CA , USA. · b Creare, LLC , Hanover , NH , USA. · c Walter Reed National Military Medical Center , Bethesda , MD , USA. · d Advanced Bionics , Valencia , CA , USA. · e University of Ottawa , Ottawa , Canada. · f Academic Medical Center , Amsterdam Public Health , Amsterdam , The Netherlands , and. · g Department of Otorhinolaryngology and Head & Neck Surgery , University Medical Center Utrecht , Utrecht , The Netherlands. ·Int J Audiol · Pubmed #29668374.

ABSTRACT: OBJECTIVE: Validate use of the Extended Speech Intelligibility Index (ESII) for prediction of speech intelligibility in non-stationary real-world noise environments. Define a means of using these predictions for objective occupational hearing screening for hearing-critical public safety and law enforcement jobs. DESIGN: Analyses of predicted and measured speech intelligibility in recordings of real-world noise environments were performed in two studies using speech recognition thresholds (SRTs) and intelligibility measures. ESII analyses of the recordings were used to predict intelligibility. Noise recordings were made in prison environments and at US Army facilities for training ground and airborne forces. Speech materials included full bandwidth sentences and bandpass filtered sentences that simulated radio transmissions. STUDY SAMPLE: A total of 22 adults with normal hearing (NH) and 15 with mild-moderate hearing impairment (HI) participated in the two studies. RESULTS: Average intelligibility predictions for individual NH and HI subjects were accurate in both studies (r CONCLUSIONS: An individual's SRT and audiogram can accurately predict the likelihood of effective speech communication in noise environments with known ESII characteristics, where essential hearing-critical tasks are performed. These predictions provide an objective means of occupational hearing screening.

12 Article Otoacoustic emissions versus audiometry in monitoring hearing loss after long-term noise exposure - a systematic review. 2018

Helleman, Hiske W / Eising, Hilde / Limpens, Jacqueline / Dreschler, Wouter A. ·Department of Clinical & Experimental Audiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. h.w.helleman@amc.nl. ·Scand J Work Environ Health · Pubmed #29542804.

ABSTRACT: Objectives The objective of this systematic review was to compare otoacoustic emissions (OAE) with audiometry in their effectiveness to monitor effects of long-term noise exposure on hearing. Methods We conducted a systematic search of MEDLINE, Embase and the non-MEDLINE subset of PubMed up to March 2016 to identify longitudinal studies on effects of noise exposure on hearing as determined by both audiometry and OAE. Results This review comprised 13 articles, with 30-350 subjects in the longitudinal analysis. A meta-analysis could not be performed because the studies were very heterogeneous in terms of measurement paradigms, follow-up time, age of included subjects, inclusion of data points, outcome parameters and method of analysis. Overall there seemed to be small changes in both audiometry and OAE over time. Individual shifts were detected by both methods but a congruent pattern could not be observed. Some studies found that initial abnormal or low-level emissions might predict future hearing loss but at the cost of low specificity due to a high number of false positives. Other studies could not find such predictive value. Conclusions The reported heterogeneity in the studies calls for more uniformity in including, reporting and analyzing longitudinal data for audiometry and OAE. For the overall results, both methods showed small changes from baseline towards a deterioration in hearing. OAE could not reliably detect threshold shifts at individual level. With respect to the predictive value of OAE, the evidence was not conclusive and studies were not in agreement. The reported predictors had low specificity.

13 Article Evaluation of an internet-based speech-in-noise screening test for school-age children. 2017

Sheikh Rashid, Marya / Dreschler, Wouter A / de Laat, Jan A P M. ·a Clinical and Experimental Audiology, Amsterdam Public Health Research Institute , Academic Medical Center (AMC) Amsterdam , Amsterdam , The Netherlands and. · b Department of Audiology , Leiden University Medical Center , Leiden , The Netherlands. ·Int J Audiol · Pubmed #28936876.

ABSTRACT: OBJECTIVE: To evaluate a Dutch online speech-in-noise screening test (in Dutch: "Kinderhoortest") in normal-hearing school-age children. Sub-aims were to study test-retest reliability, and the effects of presentation type and age on test results. DESIGN: An observational cross-sectional study at school. Speech reception thresholds (SRTs) were obtained through the online test in a training condition, and two test conditions: on a desktop computer and smartphone. The order of the test conditions was counterbalanced. STUDY SAMPLE: Ninety-four children participated (5-12 years), of which 75 children were normal-hearing (≤25 dB HL at 0.5 kHz, ≤20 dB HL at 1-4 kHz). RESULTS: There was a significant effect for test order for the two test conditions (first or second test), but not for presentation type (desktop computer or smartphone) (repeated measures analyses, F(1,75) = 12.48, p < 0.001; F(1,75) = 0.01, p = 0.982). SRT significantly improved by age year (first test: 0.25 dB SNR, 95% CI: -0.43 to -0.08, p = 0.004. Second test: 0.29 dB SNR, 95% CI: -0.46 to -0.11; p = 0.002). CONCLUSIONS: The online test shows potential for routine-hearing screening of school-age children, and can be presented on either a desktop computer or smartphone. The test should be evaluated further in order to establish sensitivity and specificity for hearing loss in children.

14 Article Laboratory evaluation of an optimised internet-based speech-in-noise test for occupational high-frequency hearing loss screening: Occupational Earcheck. 2017

Sheikh Rashid, Marya / Leensen, Monique C J / de Laat, Jan A P M / Dreschler, Wouter A. ·a Department of Clinical and Experimental Audiology , Amsterdam Public Health Research Institute, Academic Medical Center (AMC) , Amsterdam , the Netherlands and. · b Department of Audiology , Leiden University Medical Center , Leiden , the Netherlands. ·Int J Audiol · Pubmed #28587489.

ABSTRACT: OBJECTIVE: The "Occupational Earcheck" (OEC) is a Dutch online self-screening speech-in-noise test developed for the detection of occupational high-frequency hearing loss (HFHL). This study evaluates an optimised version of the test and determines the most appropriate masking noise. DESIGN: The original OEC was improved by homogenisation of the speech material, and shortening the test. A laboratory-based cross-sectional study was performed in which the optimised OEC in five alternative masking noise conditions was evaluated. STUDY SAMPLE: The study was conducted on 18 normal-hearing (NH) adults, and 15 middle-aged listeners with HFHL. RESULTS: The OEC in a low-pass (LP) filtered stationary background noise (test version LP 3: with a cut-off frequency of 1.6 kHz, and a noise floor of -12 dB) was the most accurate version tested. The test showed a reasonable sensitivity (93%), and specificity (94%) and test reliability (intra-class correlation coefficient: 0.84, mean within-subject standard deviation: 1.5 dB SNR, slope of psychometric function: 13.1%/dB SNR). CONCLUSIONS: The improved OEC, with homogenous word material in a LP filtered noise, appears to be suitable for the discrimination between younger NH listeners and older listeners with HFHL. The appropriateness of the OEC for screening purposes in an occupational setting will be studied further.

15 Article Hearing loss in children with Fabry disease. 2017

Suntjens, E / Dreschler, W A / Hess-Erga, J / Skrunes, R / Wijburg, F A / Linthorst, G E / Tøndel, C / Biegstraaten, M. ·Department of Endocrinology and Metabolism and Amsterdam Lysosome Center 'Sphinx', Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · Department of Clinical & Experimental Audiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. · Department of Ear, Nose and Throat, Head and Neck, Haukeland University Hospital, Bergen, Norway. · Department of Medicine, Haukeland University Hospital, Bergen, Norway. · Institute of Clinical Medicine, University of Bergen, Bergen, Norway. · Department of Pediatrics and Amsterdam Lysosome Centre 'Sphinx', Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. · Department of Pediatrics, Haukeland University Hospital, Bergen, Norway. · Department of Endocrinology and Metabolism and Amsterdam Lysosome Center 'Sphinx', Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.biegstraaten@amc.uva.nl. · Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.biegstraaten@amc.uva.nl. ·J Inherit Metab Dis · Pubmed #28567540.

ABSTRACT: BACKGROUND: Hearing loss (HL) is a well-known feature of Fabry disease (FD). Its presence and characteristics have mainly been studied in adult patients, while only limited data are available on the presence and degree of HL in children with FD. This prompted us to study hearing sensitivity in pediatric FD patients. METHODS: All available audiograms of the Dutch and Norwegian children with FD were retrospectively collected. First, hearing sensitivity was determined by studying hearing thresholds at low, high, and ultra-high frequencies in children with FD and comparing them to zero dB HL, i.e., healthy children. In addition, the presence and type of slight/mild HL (defined as hearing thresholds at low frequencies of 25-40 dB HL) and moderate to severe HL (hearing thresholds >40 dB HL) at first visit were analyzed. If available, follow-up data were used to estimate the natural course of hearing sensitivity and HL in children with FD. RESULTS: One-hundred-thirteen audiograms of 47 children with FD (20 boys, median age at first audiogram 12.0 (range 5.1-18.0) years) were analyzed. At baseline, slight/mild or moderate to severe HL was present in three children (6.4%, 2 boys). Follow-up measurements showed that three additional children developed HL before the age of 18. Of these six children, five had sensorineural HL, most likely caused by FD. Compared to healthy children (zero dB HL), FD children showed increased hearing thresholds at all frequencies (p < 0.01), which was most prominent at ultra-high frequencies (>8 kHz). Hearing sensitivity at these ultra-high frequencies deteriorated in a period of 5 years of follow-up. CONCLUSION: A minority of children with FD show slight/mild or moderate to severe HL, but their hearing thresholds are poorer than the reference values for normal-hearing children. Clinical trials in FD children should demonstrate whether HL can be prevented or reversed by early treatment and should specifically study ultra-high frequencies.

16 Article In situ Hearing Tests for the Purpose of a Self-Fit Hearing Aid. 2017

Boymans, Monique / Dreschler, Wouter A. ·Academic Medical Center, Amsterdam, The Netherlands. ·Audiol Neurootol · Pubmed #28434002.

ABSTRACT: This study investigated the potential and limitations of a self-fit hearing aid. This can be used in the "developing" world or in countries with large distances between the hearing-impaired subjects and the professional. It contains an on-board tone generator for in situ user-controlled, automated audiometry, and other tests for hearing aid fitting. Twenty subjects with mild hearing losses were involved. In situ audiometry showed a test-retest reliability (SD <3.7 dB) that compared well with the precision of diagnostic audiometry using headphones. There was good correspondence (SD <5.2 dB) with traditional pure-tone audiometry. In situ loudness scaling yielded important information about suprathreshold perception, which will have an added value for the selection of compression and the selection of maximum power output to be allowed in hearing aids.

17 Article Cross-sectional evaluation of an internet-based hearing screening test in an occupational setting. 2017

Sheikh Rashid, Marya / Leensen, Monique Cj / de Laat, Jan Apm / Dreschler, Wouter A. ·Department of Clinical & Experimental Audiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. m.sheikhrashid@amc.uva.nl. ·Scand J Work Environ Health · Pubmed #28273319.

ABSTRACT: Objectives The Occupational Earcheck (OEC) is an online internet test to detect high-frequency hearing loss for the purposes of occupational hearing screening. In this study, we evaluated the OEC in an occupational setting in order to assess test sensitivity, specificity, and validity. Methods A cross-sectional study was conducted in 2015, in which the optimized OEC was evaluated on 94 employees from the army and three different companies in construction and manufacturing. Subjects underwent OEC in an office-like room. Pure-tone air conduction audiometry was performed as a reference test. The OEC was repeated for a subset of subjects (N=19). Important test characteristics (ie, sensitivity and specificity, test validity, and test-retest reliability) were assessed. Results When analyzed on the individual level, the sensitivity and specificity of OEC were 90% and 77%, respectively. The speech reception threshold results correlated strongly with the pure-tone average of the frequencies 3, 4 and 6 kHz, reflecting good test validity (r=0.79). The difference between test and retest was not significant. The intra-class correlation coefficient was moderate (r=0.57), indicating a reasonable agreement between test and retest. Conclusions The OEC appears to be a suitable test for the detection of high-frequency hearing loss among noise-exposed employees, with good sensitivity and specificity values, even when performed in a semi-controlled occupational setting, though a possible learning effect should be taken into account.

18 Article Characterizing Speech Intelligibility in Noise After Wide Dynamic Range Compression. 2017

Rhebergen, Koenraad S / Maalderink, Thijs H / Dreschler, Wouter A. ·1Department of Clinical and Experimental Audiology, Academic Medical Center, Amsterdam, The Netherlands; 2Department of Otorhinolaryngology and Head & Neck Surgery, and 3Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. ·Ear Hear · Pubmed #27749521.

ABSTRACT: OBJECTIVES: The effects of nonlinear signal processing on speech intelligibility in noise are difficult to evaluate. Often, the effects are examined by comparing speech intelligibility scores with and without processing measured at fixed signal to noise ratios (SNRs) or by comparing the adaptive measured speech reception thresholds corresponding to 50% intelligibility (SRT50) with and without processing. These outcome measures might not be optimal. Measuring at fixed SNRs can be affected by ceiling or floor effects, because the range of relevant SNRs is not know in advance. The SRT50 is less time consuming, has a fixed performance level (i.e., 50% correct), but the SRT50 could give a limited view, because we hypothesize that the effect of most nonlinear signal processing algorithms at the SRT50 cannot be generalized to other points of the psychometric function. DESIGN: In this article, we tested the value of estimating the entire psychometric function. We studied the effect of wide dynamic range compression (WDRC) on speech intelligibility in stationary, and interrupted speech-shaped noise in normal-hearing subjects, using a fast method-based local linear fitting approach and by two adaptive procedures. RESULTS: The measured performance differences for conditions with and without WDRC for the psychometric functions in stationary noise and interrupted speech-shaped noise show that the effects of WDRC on speech intelligibility are SNR dependent. CONCLUSIONS: We conclude that favorable and unfavorable effects of WDRC on speech intelligibility can be missed if the results are presented in terms of SRT50 values only.

19 Article Application of the online hearing screening test "Earcheck": Speech intelligibility in noise in teenagers and young adults. 2016

Rashid, Marya Sheikh / Leensen, Monique C J / Dreschler, Wouter A. ·Clinical and Experimental Audiology, ENT Department, Academic Medical Center (AMC) Amsterdam, The Netherlands. ·Noise Health · Pubmed #27991462.

ABSTRACT: OBJECTIVE: The objective was to describe the speech intelligibility in noise test results among Dutch teenagers and young adults aged 12-24 years, using a national online speech reception threshold (SRT) test, the Earcheck. A secondary objective was to assess the effect of age and gender on speech intelligibility in noise. DESIGN: Cross-sectional SRT data were collected over a 5-year period (2010-2014), from participants of Earcheck. Regression analyses were performed, with SRT as the dependent variable, and age and gender as explaining variables. To cross-validate the model, data from 12- to 24-year olds from the same test distributed by a hearing aid dispenser (Hoorscan) were used. RESULTS: In total, 96,803 valid test results were analyzed. The mean SRT score was -18.3 dB signal-to-noise ratio (SNR) (standard deviation (SD) = 3.7). Twenty-five percent of the scores was rated as insufficient or poor. SRT performance significantly improved with increasing age for teenagers aged 12-18 years by 0.49 dB SNR per age-year. A smaller age-effect (0.09 dB SNR per age-year) was found for young adults aged 19-24 years. Small differences between male and female users were found. CONCLUSION: Earcheck generated large quantities of national SRT data. The data implied that a substantial number of users of Earcheck may have some difficulty in understanding speech in noise. Furthermore, the results of this study showed an effect of gender and age on SRT performance, suggesting an ongoing maturation of speech-in-noise performance into late adolescence. This suggests the use of age-dependent reference values, but for this purpose, more research is required.

20 Article A Profiling System for the Assessment of Individual Needs for Rehabilitation With Hearing Aids. 2016

Dreschler, Wouter A / de Ronde-Brons, I. ·Academic Medical Centre, University of Amsterdam, The Netherlands w.a.dreschler@amc.uva.nl. · Academic Medical Centre, University of Amsterdam, The Netherlands. ·Trends Hear · Pubmed #27815547.

ABSTRACT: This study focuses on the development of a profiling system to specify the needs of hearing-aid candidates. As a basis for the profile of compensation needs, we used a slightly modified version of the Amsterdam Inventory of Disability and Handicap, combined with the well-known Client-Oriented Scale of Improvement (COSI). The first questionnaire results in scores for six audiological dimensions: detection, speech in quiet, speech in noise, localization, focus or discrimination, and noise tolerance. The goal of this study was to determine whether the six dimensions derived from the disability questionnaire are appropriate to also categorize individual COSI targets. The results show a good agreement between eight audiologists in the categorization of COSI goals along the six dimensions. The results per dimension show that the dimension focus or discrimination can be regarded as superfluous. Possible additional dimensions were tinnitus and listening effort. The results indicate that it is possible to translate individual user needs (administered using COSI) into more general dimensions derived from a disability questionnaire. This allows to summarize the compensation needs for individual patients in a profile of general dimensions, based on the degree of disability and the individual user needs. This profile can be used as a starting point in hearing aid selection. This approach also offers a well-structured method for the evaluation of the postfitting results.

21 Article Mutations in TBL1X Are Associated With Central Hypothyroidism. 2016

Heinen, Charlotte A / Losekoot, Monique / Sun, Yu / Watson, Peter J / Fairall, Louise / Joustra, Sjoerd D / Zwaveling-Soonawala, Nitash / Oostdijk, Wilma / van den Akker, Erica L T / Alders, Mariëlle / Santen, Gijs W E / van Rijn, Rick R / Dreschler, Wouter A / Surovtseva, Olga V / Biermasz, Nienke R / Hennekam, Raoul C / Wit, Jan M / Schwabe, John W R / Boelen, Anita / Fliers, Eric / van Trotsenburg, A S Paul. ·Department of Endocrinology and Metabolism (C.A.H., O.V.S., A.B., E.F.), Clinical Genetics (M.A.), and Clinical and Experimental Audiology (W.A.D.), Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands · Departments of Paediatric Endocrinology (C.A.H., N.Z.-S., A.S.P.v.T.), Radiology (R.R.v.R.), and Paediatrics (R.C.H.), Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, 1100 DD Amsterdam, The Netherlands · Departments of Clinical Genetics (M.L., Y.S., G.W.E.S.), Paediatrics (S.D.J., W.O., J.M.W.), and Endocrinology and Metabolism (S.D.J., N.R.B.), Leiden University Medical Centre, 2300 RC Leiden, The Netherlands · Henry Wellcome Laboratories of Structural Biology (P.J.W., L.F., J.W.R.S.), Department of Molecular and Cell Biology, University of Leicester, Leicester LE1 7RH, United Kingdom · and Department of Paediatric Endocrinology (E.L.T.v.d.A.), Erasmus Medical Centre, 3000 CB Rotterdam, The Netherlands. ·J Clin Endocrinol Metab · Pubmed #27603907.

ABSTRACT: CONTEXT: Isolated congenital central hypothyroidism (CeH) can result from mutations in TRHR, TSHB, and IGSF1, but its etiology often remains unexplained. We identified a missense mutation in the transducin β-like protein 1, X-linked (TBL1X) gene in three relatives diagnosed with isolated CeH. TBL1X is part of the thyroid hormone receptor-corepressor complex. OBJECTIVE: The objectives of the study were the identification of TBL1X mutations in patients with unexplained isolated CeH, Sanger sequencing of relatives of affected individuals, and clinical and biochemical characterization; in vitro investigation of functional consequences of mutations; and mRNA expression in, and immunostaining of, human hypothalami and pituitary glands. DESIGN: This was an observational study. SETTING: The study was conducted at university medical centers. PATIENTS: Nineteen individuals with and seven without a mutation participated in the study. MAIN OUTCOME MEASURES: Outcome measures included sequencing results, clinical and biochemical characteristics of mutation carriers, and results of in vitro functional and expression studies. RESULTS: Sanger sequencing yielded five additional mutations. All patients (n = 8; six males) were previously diagnosed with CeH (free T CONCLUSIONS: TBL1X mutations are associated with CeH and hearing loss. FT4 concentrations in mutation carriers vary from low-normal to values compatible with CeH.

22 Article Selecting Appropriate Tests to Assess the Benefits of Bilateral Amplification With Hearing Aids. 2016

van Schoonhoven, Jelmer / Schulte, Michael / Boymans, Monique / Wagener, Kirsten C / Dreschler, Wouter A / Kollmeier, Birger. ·Department of Clinical and Experimental Audiology, Academic Medical Centre, Amsterdam, The Netherlands jvanschoonhoven@amc.nl. · Hörzentrum Oldenburg GmbH, Oldenburg, Germany Cluster of Excellence Hearing4all, Oldenburg, Germany. · Department of Clinical and Experimental Audiology, Academic Medical Centre, Amsterdam, The Netherlands. · Hörzentrum Oldenburg GmbH, Oldenburg, Germany Cluster of Excellence Hearing4all, Oldenburg, Germany Medizinische Physik, Carl-von-Ossietzky Universität Oldenburg, Germany. ·Trends Hear · Pubmed #27460871.

ABSTRACT: The aim of this study was to investigate the effect of bilateral hearing aids (HA) in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users.

23 Article Adjustments of the amplitude mapping function: Sensitivity of cochlear implant users and effects on subjective preference and speech recognition. 2016

Theelen-van den Hoek, Femke L / Boymans, Monique / van Dijk, Bas / Dreschler, Wouter A. ·a Clinical and Experimental Audiology , Academic Medical Center , Amsterdam , The Netherlands and. · b Cochlear Technology Centre , Mechelen , Belgium. ·Int J Audiol · Pubmed #27447758.

ABSTRACT: OBJECTIVE: In sound processors of cochlear implant (CI) users, input sound signals are analysed in multiple frequency channels. The amplitude mapping function (AMF) is the output compression function dictating the conversion from (acoustical) channel output levels to (electrical) current levels used for electrode stimulation. This study focused on the detectability of AMF adjustments by CI users and the effects of detectable AMF adjustments on subjective preference and performance. DESIGN: Just noticeable differences (JNDs) for AMF settings were measured for pre-processed sentences at 60 dB SPL in quiet and noise. Three AMF settings, ranging twice the JND, were used during a take-home trial period of 12 days. Subjective ratings were collected and speech recognition in quiet and noise was measured. STUDY SAMPLE: JND measurements: 17 CI users. Field experiment: 15 CI users. RESULTS: JNDs for AMF settings varied among subjects and were similar in quiet and noise. A steeper AMF in the lower part was advantageous for speech recognition in quiet at soft levels. Subjective ratings showed limited agreement with speech recognition, both in quiet and noise. CONCLUSIONS: CI users may benefit from different AMF settings in different listening situations regarding subjective preference and speech perception, especially for speech in quiet.

24 Article The long-term results of speech perception in elderly cochlear implant users. 2016

Jolink, C / Helleman, H W / van Spronsen, E / Ebbens, F A / Ravesloot, M J L / Dreschler, W A. ·a Department of Otorhinolaryngology , Academic Medical Centre , Amsterdam , The Netherlands. · b Clinical and Experimental Audiology , Academic Medical Centre , Amsterdam , The Netherlands. ·Cochlear Implants Int · Pubmed #27078518.

ABSTRACT: OBJECTIVES: To evaluate the speech discrimination performance of elderly post-lingually deafened cochlear implant (CI) users and the stability of performance over time relative to a control group of younger CI users. METHODS: The study group consisted of 20 native Dutch speaking, post-lingually deafened CI users, aged 70 or older at the time of implantation. Controls were patients aged 40-60 years at implantation and included according to the same inclusion criteria (except age). Linear mixed models assessed speech recognition scores between groups, the variability of their performance, and stability over time. RESULTS: 20 elderly and 37 controls were included. The mean follow-up was 4.4 and 5.3 years for elderly and controls, respectively. There was no significant difference in average speech discrimination between both groups. The elderly group had a larger intra-subject variability over time. There was no significant effect of follow-up on the speech discrimination, indicating a stable performance over time. DISCUSSION: This study has a longer follow-up than methodologically comparable previous studies. We found no difference in speech discrimination between elderly patients and controls and no deterioration of performance over time. The subjects in the elderly group exhibit a larger variability around their mean performance. CONCLUSION: Speech recognition in both elderly and younger adult CI users is stable over time and is not significantly related to the age of implantation.

25 Article Hearing loss in survivors of childhood head and neck rhabdomyosarcoma: a long-term follow-up study. 2016

Schoot, R A / Theunissen, E A R / Slater, O / Lopez-Yurda, M / Zuur, C L / Gaze, M N / Chang, Y-C / Mandeville, H C / Gains, J E / Rajput, K / Pieters, B R / Davila Fajardo, R / Talwar, R / Caron, H N / Balm, A J M / Dreschler, W A / Merks, J H M. ·Department of Paediatric Oncology, Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands. · Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands. · Department of Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. · Department of Epidemiology and Biostatistics, the Netherlands Cancer Institute, Amsterdam, the Netherlands. · Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK. · Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, Sutton, UK. · Department of Audiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. · Department of Radiation Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. · Department of Otorhinolaryngology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. · Department of Audiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. ·Clin Otolaryngol · Pubmed #26293165.

ABSTRACT: OBJECTIVES: To determine the hearing status of survivors treated for head and neck rhabdomyosarcoma (HNRMS) at long-term follow-up. DESIGN: Cross-sectional long-term follow-up study. SETTING: Tertiary comprehensive cancer centre. PARTICIPANTS: Survivors treated for HNRMS during childhood in two concurrent cohorts; survivors in London had been treated with external beam radiotherapy (EBRT-based local therapy); survivors in Amsterdam were treated with AMORE (Ablative surgery, MOuld technique afterloading brachytherapy and surgical REconstruction) if feasible, otherwise EBRT (AMORE-based local therapy). MAIN OUTCOME MEASURES: We assessed hearing status of HNRMS survivors at long-term follow-up. Hearing thresholds were obtained by pure-tone audiometry. METHODS: We assessed the hearing thresholds, the number of patients with clinically relevant hearing loss and hearing impairment graded according to the Common Terminology Criteria for Adverse Events version 4.0 (CTCAEv4) and Boston criteria. Furthermore, we compared hearing loss between survivors treated with EBRT-based local therapy (London) and AMORE-based local therapy (Amsterdam). RESULTS: Seventy-three survivors were included (median follow-up 11 years). We found clinically relevant hearing loss at speech frequencies in 19% of survivors. Multivariable analysis showed that survivors treated with EBRT-based treatment and those with parameningeal tumours had significantly more hearing impairment, compared to survivors treated with AMORE-based treatment and non-parameningeal tumours. CONCLUSIONS: One in five survivors of HNRMS developed clinically relevant hearing loss. AMORE-based treatment resulted in less hearing loss compared to EBRT-based treatment. As hearing loss was highly prevalent and also occurred in survivors with orbital primaries, we recommend systematic audiological follow-up in all HNRMS survivors.

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