Classification, Pathophysiology, Genetics, And Role of Lifestyle Medicine in Presbycusis

Abstract

Presbycusis, which is age-related hearing loss is hearing loss usually seen in the elderly due to advancing in age, marked by a higher hearing threshold usually worse at higher frequencies, which impairs speech discrimination in noise. Genetic predisposition is an important factor in the aetiology of presbycusis. Presbycusis was previously classified into 4 different types, and recently into 6 types with the addition of mixed, and indeterminate types of presbycusis, with each type reflecting a peculiar audiometric configuration and speech discrimination percentage. Artificial intelligence has utilized this peculiar audiometric feature in diagnosis of genetic hearing loss. and recently, lifestyle medicine is being employed to highlight the benefit of preventive medicine in the management of hearing loss. Human studies have remained the trend of genetic hearing loss research in recent years. There is an overwhelming interest, with reasonable insight gained into the pathophysiology and genetics of ARHL, but the interaction of genetics, lifestyle, and environment certainly complicates our ability to separate their individual contributions to this pathology. There is need to improve research in the role of lifestyle medicine in curbing presbycusis.

Keywords: Presbycusis; age-related hearing loss; audiometry; genetics; lifestyle medicine

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Accuracy of Laryngoscopy for Quantitative Vocal Fold Analysis in Combination with AI, A Cohort Study of Manual Artefacts

 

Abstract

Introduction: A cohort of high-speed videoendoscopies was evaluated for usability for deep learning. The aim of our study was to find the percentage of our high-speed videos (15.732) that could be used for deep learning (AI). A screening of the material showed that some videos had artefacts, making them non usable for deep learning.

Material: A randomization was made with Wolfram Alpha random number generator selecting between 15.732 videos from 7.909 patients. The various non usable videos are described including the rear parts of the vocal folds not seen, the epiglottis or uvula blocking vision, parts of the vocal folds not seen, no vibration of the vocal folds, persistent constricted larynx, picture taken from an oblique angle, the front part of the vocal folds not seen, and parts of the arytenoid region not seen.

Method: Assuming the assessments are independent with regards to whether there is a finding, the total number of assessments with a given finding is binomial distributed. With 100 assessments, an observed incidence of 1, 10 and 25 findings will result in estimated 95% confidence intervals of [0%-3%], [4%-16%] and [17%-33%], respectively. 95% confidence intervals are calculated as Wald test using the asymptotic Normal distribution assumption of the estimated proportion in the binomial distribution. Assuming the incidence of findings for each of the different findings was below 25%, the expected length of the 95% confidence interval is 16%-point (33-17), with 200 and 500 assessments, the corresponding length is 14%-point and 8%-point, respectively. Based on these calculations 100 randomised films were sufficient to be used for calculations.

Results and Conclusion: The prospective cohort study of high-speed videos covered 12 years from the February 2007 to January 2019 in an otorhinolaryngology medical centre. 7.909 patients with a total of 15.732 high-speed video films of the larynx including the vocal folds had been consecutively sampled (4.000 frames per second, Richard Wolf Ltd. endocam 5562). Observations on high-speed video for the usable versus non usable videos with 95% confidence intervals, showed that only 51% were usable. The interesting result is that oblique angle pictures (10%) as well as insufficient pictures of the front of the vocal folds and arytenoids (14%) were the largest groups of the non-usable. They can be augmented by the examiner in the future. Various video and deep learning programs are discussed.

Keywords: Manual artifacts; deep learning; vocal fold analysis; quantitative measures

Abbreviations: AI: Artificial Intelligence; OCT: Optical Coherence Tomography

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Evaluation of the Gamification Effectiveness of an Application for Reducing Dizziness Disability in Children

 

Abstract

Objective: To verify the effectiveness of the use of gamified elements in the Dizziness Kids application, based on the analysis of the results obtained by the patients’ performance, interactivity, and productivity..

Methodology: This is a descriptive, exploratory study with a quantitative approach, consisting of a convenience sample of twelve male and female children up to 12 years old with the symptom of dizziness. The sample was divided into 2 groups: Study Group, composed of 6 children who were submitted to the stimuli of the Dizziness App Kids and Control Group, composed of 6 children who interacted with the Dizziness App version.

Results: Therapy through the Dizziness Kids App made it possible to reduce the score on the DHI-CA / SF questionnaire, improve the symptoms and quality of life of the children studied.

Conclusion: The inclusion of gamification elements in the mobile application Dizziness App Kids showed the motivation of the participants in the intervention, signaling positive results.

Keywords: Dizziness; kids; exercise therapy; applications

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Audiometric Thresholds and Tinnitus Functional Index of Adult Patients with Tinnitus

 

Abstract

Introduction: Tinnitus is a common irritating symptom. Tinnitus functional index (TFI) and measurements of tinnitus match are useful tools for evaluating tinnitus impact. This study aimed at comparing the hearing thresholds to the Quality of life (QoL) of tinnitus patients.

Methodology: Clinical assessment, Pure tone audiometry (PTA), and QoL assessment were carried out. The data gathered from the study were evaluated and results were interpreted.

Results: The mean age of tinnitus subjects was 51.7 years. Male to female ratio was 1:1.4. Higher number of subjects experienced chronic tinnitus. High frequency and the tinnitus loudness above 15dB were the highest among them. The association between the QoL assessment and tinnitus loudness match (TLM) was statistically significant. Similarly, there was positive correlation between the TFI scores and pure tone average (PTAv), tinnitus pitch match and TLM.

Conclusion: Most patients described their experience of tinnitus as a big problem. There was a positive correlation between the pure tone average, TLM and the QoL measure. Routine measurement of tinnitus distress with TFI and psychoacoustic assessments were advocated.

Keywords: Tinnitus functional index; quality of life; pure tone average; psychoacoustic assessments

Abbreviations: TFI: Tinnitus Functional Index; QoL: Quality of Life; PTA: Pure Tone Audiometry; TLM: Tinnitus Loudness Match

 

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