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Hearing loss and deafness: Normal hearing and impaired hearing

The actual organ of hearing is the cochlea in the inner ear. The cochlea receives sound waves and passes them on to the brain. This works smoothly in people with normal hearing. The ears receive sound waves and change them into signals which are sent along nerves to the brain. The brain then analyzes the signals, recognizes them as sounds and interprets them – for instance, as soft music, loud honking or human voices.Sound waves are created when an object moves, for example when a guitar string or speaker cone vibrates. Whether we hear a sound depends both on the power of the sound (“sound level” or “sound pressure level”) as well as on the frequency (or “pitch”) of the vibration.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 12, 2014

Hearing loss and deafness: Overview

In Germany and other countries, it is routine practice to test the hearing of newborn babies, to be able to diagnose and treat hearing problems early on. This can help improve language development in hearing-impaired children.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 12, 2014

Hearing loss and deafness: Hearing tests in newborns: Are there advantages?

Doing screening tests in all newborns makes it possible to diagnose and treat hearing problems sooner. This can improve language development in children who have hearing problems.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: 2006

Hearing loss and deafness: Hearing tests in newborns

In Germany and other countries,  newborn babies are routinely given hearing tests in order to detect and treat hearing impairments as early as possible. This can improve early language development in children who have hearing problems.Nearly all babies can hear well: 997 out of 1,000 babies are born with normal hearing. Up to 3 out of 1,000 newborns have a moderate or severe hearing impairment. Although these children hear a little worse than normal, most of them are not deaf. Without early hearing tests, hearing problems are often first detected when a child is between two and four years old. But hearing tests in newborns cannot detect hearing impairments in all children because some hearing impairments only develop later on in childhood.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 12, 2014

Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss

Idiopathic sudden sensorineural hearing loss (ISSHL) is sudden hearing loss where clinical assessment fails to reveal a cause. Hearing loss may vary from partial to total loss, and is usually accompanied by tinnitus. It has been frequently considered that ISSHL may have a vascular origin (i.e. is related to the blood circulatory system) and vasodilators and rheological substances are widely used as treatments. Vasodilators are drugs which widen blood vessels and thus improve blood flow. Vasoactive/rheological substances increase flow through blood vessels in other ways (such as by altering the viscosity of fluid). We found three trials, involving 189 participants, which showed improvement in hearing thresholds in those treated with vasodilators compared to control groups. However, as the number of patients included in the studies was small, and there were differences in the type, dosage and duration of vasodilator treatment used in each of these studies, the results could not be combined to reach a conclusion. The effectiveness of vasodilators in the treatment of ISSHL could not be proven. Further research is needed. 

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Hyperbaric oxygen for sudden hearing loss and tinnitus (ringing in the ears) of unknown cause

Idiopathic sudden sensorineural hearing loss (ISSHL) is common and often results in permanent hearing loss. It therefore has a high impact on the well‐being of those affected. Tinnitus (abnormal persistent noises or ringing in the ear) is similarly common and often accompanies the hearing loss. Although the cause of these complaints is not clear, they may be related to a lack of oxygen secondary to a vascular problem not yet identified. Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a specially designed chamber and it is sometimes used as a treatment to increase the supply of oxygen to the ear and brain in an attempt to reduce the severity of hearing loss and tinnitus.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antiviral drugs for sudden hearing loss (without known cause)

Idiopathic sudden sensorineural hearing loss (ISSHL) is sudden loss of hearing where clinical assessment has failed to reveal a cause. Patients may also suffer from additional symptoms such as tinnitus (a background ringing noise), together with dizziness and a sensation of fullness in the ear. Prompt investigation is essential to identify and treat the hearing impairment. In a large proportion of patients, however, no cause can be found.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children

Evidence suggests that grommets only offer a short‐term hearing improvement in children with simple glue ear (otitis media with effusion or OME) who have no other serious medical problems or disabilities. No effect on speech and language development has been shown.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Steroids for the treatment of sudden hearing loss with unknown cause

A sudden onset of hearing loss due to disease of the hearing organs is a medical emergency and requires prompt recognition and treatment. In addition to the hearing impairment, patients may also suffer from symptoms of tinnitus (background ringing noise), a sensation of ear fullness and dizziness. In many instances medical specialists are able to find the cause and treat the hearing impairment. However, in a large proportion of patients, no known cause of the sudden hearing loss can be found. Steroids are commonly used to treat patients with sudden hearing loss of an unknown origin. The specific action of the steroids in the hearing apparatus is uncertain. It is possible that the steroid treatment improves hearing because of its ability to reduce inflammation and oedema (swelling) in the hearing organs. The review of the trials showed a lack of good‐quality evidence for the effectiveness of steroids in the treatment of sudden hearing loss of an unknown origin. The quality of the trials was generally low and more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Oral or topical nasal steroids for hearing loss associated with otitis media with effusion (glue ear) in children

Glue ear (otitis media with effusion ‐ OME) is sticky fluid in the middle ear that does not cause pain or fever but can reduce hearing. Steroid drugs (taken orally or as nose spray) are sometimes used to try to speed up the resolution of effusion and so prevent hearing loss. Other treatment options include oral antibiotics and other medicines, or surgical procedures such as grommets (ventilation tubes). This review of trials found that oral steroids (especially when used in combination with antibiotics) speeded up the resolution of OME in the short term. However, there was no long‐term evidence to show lasting benefit or improved hearing. There was no evidence that using steroid drugs as a nose spray benefited children with OME.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Autoinflation for hearing loss associated with otitis media with effusion (glue ear)

Otitis media with effusion (OME) or 'glue ear' is very common in children and the hearing loss and discomfort, especially where the effusion is bilateral and long‐lasting, may lead to problems with language, development and behaviour. There are a number of treatment options including steroids, antibiotics, decongestants, antihistamines and surgery (the insertion of grommets (ventilation tubes)). Grommet insertion is one of the commonest operations of childhood. The best treatment strategy remains controversial, however, as glue ear often resolves spontaneously within a few months.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Drugs to prevent hearing loss in children receiving platinum chemotherapy for cancer

Platinum‐based chemotherapy, including cisplatin, carboplatin and/or oxaliplatin, is used in the treatment of different types of childhood cancer. Unfortunately, one of the most important adverse effects of platinum chemotherapy is hearing loss. This can occur not only during treatment but also years after the end of treatment. Although hearing loss is not life‐threatening the loss of hearing, especially during the first three years of life, may lead to difficulties with school performance and psychosocial functioning. Prevention of platinum‐induced hearing loss is thus very important and might improve the quality of life of childhood cancer patients and survivors treated with platinum‐based chemotherapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions to prevent hearing loss caused by noise at work

We found one study that showed that noise levels decreased after the implementation of stricter legislation in the mining industry. Even though case studies show that substantial reductions in noise levels in workplaces can be achieved, there were no further reports of controlled studies that this can be implemented and maintained at a larger scale.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Non‐speech oral motor treatment for children with developmental speech sound disorders

We reviewed the evidence on the effects of non‐speech oral motor treatment (NSOMT) for treating children with developmental speech sound disorders who have speech errors.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Treatment for speech disorder in Friedreich ataxia and other hereditary ataxia syndromes (inherited disorders of movement co‐ordination)

We reviewed the evidence about the effects of treatment on speech difficulties in people with Friedreich ataxia and other hereditary ataxias.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Hearing aids for tinnitus in people with hearing loss

Tinnitus describes 'ringing', 'whooshing' or 'hissing' sounds that are heard in the absence of any corresponding external sound. About 10% of people experience tinnitus and for some it has a significant negative impact on their quality of life. Tinnitus is commonly associated with some form of hearing loss and is possibly the result of hearing loss‐related changes in brain activity. It is logical to think, therefore, that providing people who have hearing loss and tinnitus with a hearing aid will not only improve their ability to hear sound but will also reduce their tinnitus symptoms. Hearing aids increase the volume at which people hear external sounds so this may help mask or cover up the tinnitus sound. They also improve communication, which may reduce the symptoms often associated with tinnitus such as stress or anxiety. Hearing aids may also improve tinnitus symptoms by reducing or reversing abnormal types of nerve cell activity that are thought to be related to tinnitus. The purpose of this review is to evaluate the evidence from high‐quality clinical trials that try to work out the effects hearing aids have on people's tinnitus. We particularly wanted to look at how bothersome their tinnitus is, how depressed or anxious tinnitus patients are and whether hearing aid use has an effect on patterns of brain activity thought to be associated with tinnitus.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Auditory‐verbal therapy for promoting spoken language development in children with permanent hearing impairments

Permanent hearing impairment greatly restricts a child's speech and language development and hinders his or her behavioural, cognitive and social functioning. Although technological devices, such as hearing aids and cochlear implants, enable the child to hear spoken words, they fail to teach the child how to listen, how to process language or how to talk.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Different infusion durations for preventing platinum‐induced hearing loss in children with cancer

Platinum‐based chemotherapy, including cisplatin, carboplatin or oxaliplatin, or a combination of these, is used to treat different types of childhood cancer. Unfortunately, one of the most important adverse effects of platinum chemotherapy is hearing loss. This can occur not only during treatment but also years after the end of treatment. Although it is not life‐threatening, the loss of hearing, especially during the first three years of life, may lead to difficulties with school performance and psychosocial functioning. Therefore, prevention of platinum‐induced hearing loss is very important and might improve the quality of life of children undergoing cancer treatment and those who have survived treatment with platinum‐based chemotherapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions to improve hearing aid use in adult auditory rehabilitation

We wanted to know if any interventions helped people to wear their hearing aids more. We measured effects over the short term (less than 12 weeks), medium term (from 12 to 52 weeks) and long term (one year plus).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Testing Treatments: Better Research for Better Healthcare. 2nd edition

How do we know whether a particular treatment really works? How reliable is the evidence? And how do we ensure that research into medical treatments best meets the needs of patients? These are just a few of the questions addressed in a lively and informative way in Testing Treatments. Brimming with vivid examples, Testing Treatments will inspire both patients and professionals.

Pinter & Martin.

Version: 2011

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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