Recommendations on Collecting and Storing Samples for Genetic Studies in Hearing and Tinnitus Research

Objectives: Research on the genetic basis of tinnitus is still in its first steps. A group of scientists dedicated to tinnitus genetics within European Tinnitus Network (TINNET) network recognize that further progress requires multicenter collaborative efforts for defining contributing genes. The purpose of the present work is to provide instructions regarding collection, processing, storage, and shipment of samples intended for genetic studies in auditory research. Design: One part of the recommendations has a general character; another part is of particular importance for auditory healthcare practitioners such as otolaryngology physicians, audiologists, and general practitioners. Results: We provide a set of instructions and various options for obtaining samples. We give advice regarding sample processing, storage, and shipment and define the minimal and essential clinical information that should accompany the samples collected for genetic processing. Conclusions: These recommendations offer a basis to standardize and optimize collaborations between geneticists and healthcare practitioners specialized in tinnitus and hearing disorders. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. ACKNOWLEDGMENTS: The work was supported by an independent research program funded under the Biomedicine and Molecular Biosciences European Cooperation in Science and Technology (COST) Action framework (TINNET, BM1306) and from the European Union H2020 research and innovation program under the MSC-ITN 722046 (Schlee et al. 2017). A.J.S. received funding from German Tinnitus Foundation, Sonnenfeld Fundation, and Dürr Foundation. C.R.C. received funding from Karolinska Institutet, Tysta Skolan, Hörselforskningsfonden, Magnus Bergvalls, and Lars Hiertas Minne. J.A.L.-E. received funding from Meniere Society, UK, and the Luxembourg National Research Fund (INTER/Mobility/17/11772209). Publication fees were partially supported by Polytechnic Institute of Setúbal, Portugal. The authors have no conflicts of interest to disclose. Received November 30, 2017; accepted April 6, 2018. Address for correspondence: Jose A. Lopez-Escamez, Otology and Neurotology Group CTS495, GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, Avda de la Ilustración, 114, 18016 Granada, Spain. E-mail: antonio.lopezescamez@genyo.es Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Recommendations on Collecting and Storing Samples for Genetic Studies in Hearing and Tinnitus Research

Objectives: Research on the genetic basis of tinnitus is still in its first steps. A group of scientists dedicated to tinnitus genetics within European Tinnitus Network (TINNET) network recognize that further progress requires multicenter collaborative efforts for defining contributing genes. The purpose of the present work is to provide instructions regarding collection, processing, storage, and shipment of samples intended for genetic studies in auditory research. Design: One part of the recommendations has a general character; another part is of particular importance for auditory healthcare practitioners such as otolaryngology physicians, audiologists, and general practitioners. Results: We provide a set of instructions and various options for obtaining samples. We give advice regarding sample processing, storage, and shipment and define the minimal and essential clinical information that should accompany the samples collected for genetic processing. Conclusions: These recommendations offer a basis to standardize and optimize collaborations between geneticists and healthcare practitioners specialized in tinnitus and hearing disorders. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. ACKNOWLEDGMENTS: The work was supported by an independent research program funded under the Biomedicine and Molecular Biosciences European Cooperation in Science and Technology (COST) Action framework (TINNET, BM1306) and from the European Union H2020 research and innovation program under the MSC-ITN 722046 (Schlee et al. 2017). A.J.S. received funding from German Tinnitus Foundation, Sonnenfeld Fundation, and Dürr Foundation. C.R.C. received funding from Karolinska Institutet, Tysta Skolan, Hörselforskningsfonden, Magnus Bergvalls, and Lars Hiertas Minne. J.A.L.-E. received funding from Meniere Society, UK, and the Luxembourg National Research Fund (INTER/Mobility/17/11772209). Publication fees were partially supported by Polytechnic Institute of Setúbal, Portugal. The authors have no conflicts of interest to disclose. Received November 30, 2017; accepted April 6, 2018. Address for correspondence: Jose A. Lopez-Escamez, Otology and Neurotology Group CTS495, GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, Avda de la Ilustración, 114, 18016 Granada, Spain. E-mail: antonio.lopezescamez@genyo.es Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Smoking Associated with Hearing Impairment in Infants

​​Exposure to tobacco smoke prenatally and postnatally is associated with hearing impairment in children, according to researchers in Japan (Paediatr Perinat Epidemiol. 2018 Jun 5. doi: 10.1111/ppe.12477. [Epub ahead of print]). They conducted a retrospective study of 50,734 children born between 2004 and 2010 in Kobe City, and measured smoking during pregnancy and exposure to tobacco smoke at 4 months with parent-reported questionnaires. 

The prevalence of hearing impairment at 3 years old was 4.6 percent. Compared with children not exposed to tobacco smoke prenatally and at 4 months, children exposed to only maternal smoking during pregnancy had a 26 percent increased relative risk, those exposed to only second-hand smoke at 4 months had a 30 percent increased relative risk, those exposed to smoking only during pregnancy had a 68 percent increased relative risk, and those exposed to both smoking during pregnancy and second-hand smoke at 4 months had a 2.4-time increased relative risk.
 
Senior author of the study, Koji Kawakami, MD, PhD, a professor at Kyoto University, said this study clearly shows that preventing exposure to tobacco smoke during pregnancy and postnatally may reduce the risk of hearing problems in children. “The findings remind us of the need to continue strengthening interventions to prevent smoking before and during pregnancy and exposure to second-hand smoke in children,” he said in a press release. 

Published: 6/8/2018 11:05:00 AM

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Smoking Associated with Hearing Impairment in Infants

​​Exposure to tobacco smoke prenatally and postnatally is associated with hearing impairment in children, according to researchers in Japan (Paediatr Perinat Epidemiol. 2018 Jun 5. doi: 10.1111/ppe.12477. [Epub ahead of print]). They conducted a retrospective study of 50,734 children born between 2004 and 2010 in Kobe City, and measured smoking during pregnancy and exposure to tobacco smoke at 4 months with parent-reported questionnaires. 

The prevalence of hearing impairment at 3 years old was 4.6 percent. Compared with children not exposed to tobacco smoke prenatally and at 4 months, children exposed to only maternal smoking during pregnancy had a 26 percent increased relative risk, those exposed to only second-hand smoke at 4 months had a 30 percent increased relative risk, those exposed to smoking only during pregnancy had a 68 percent increased relative risk, and those exposed to both smoking during pregnancy and second-hand smoke at 4 months had a 2.4-time increased relative risk.
 
Senior author of the study, Koji Kawakami, MD, PhD, a professor at Kyoto University, said this study clearly shows that preventing exposure to tobacco smoke during pregnancy and postnatally may reduce the risk of hearing problems in children. “The findings remind us of the need to continue strengthening interventions to prevent smoking before and during pregnancy and exposure to second-hand smoke in children,” he said in a press release. 

Published: 6/8/2018 11:05:00 AM

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The Effect of Presentation Level on the SCAN-3 in Children and Adults

Purpose

The pediatric and adult versions of the SCAN-3 test (Keith, 2009a, 2009b) are widely used to screen and diagnose auditory processing disorders. According to the instruction manual, the test administration is flexible in that it may be administered through an audiometer at 50 dB HL or a portable CD player at the patient or administrator's most comfortable listening level (MCL). Because MCL may vary across individuals, even in those with normal hearing sensitivity, this study explored whether the presentation level affected scores on the SCAN-3 for both pediatric and adult populations.

Method

Twenty-two young adults and 23 children with normal hearing sensitivity and middle ear function were administered the SCAN-3 three different times at 1-month intervals, at 40, 50, and 60 dB HL. The stimulus level of the SCAN-3 was counterbalanced across participants to eliminate test order effects. In addition, MCL was measured in the pediatric participants during each session.

Results

MCL varied significantly across children as well as between test sessions, ranging from 40 to 75 dB HL. Performance on 3 of the 4 subtests administered, as well as composite scores, was significantly different across presentation levels (based on scaled scores). Effect sizes were also calculated and found to be strong. The number of composite scores interpreted as within normal limits versus borderline or disordered was also statistically different across presentation levels.

Conclusions

Presentation level appears to affect performance on auditory figure ground, monaural low-redundancy, and binaural integration types of auditory processing tasks that are measured by the SCAN-3. In children, MCL was found to vary significantly both between and within individuals. Although several professions outside audiology are qualified to administer the SCAN-3, it is likely that many of these individuals administer the test without an audiometer and would use an MCL to determine presentation level. It is recommended that SCAN-3 users administer the test through an audiometer at 50 dB HL, rather than with a portable CD player, using MCL values to avoid any presentation level effects.

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Audiology Students' Perspectives of Enacting and Learning Clinical Communication: A Qualitative Interview and Video Reflexivity Study

Purpose

Effective clinical communication is pivotal to the provision of quality hearing health care. To date, audiology students reportedly felt ill-prepared when counseling patients about their hearing impairment, yet there is a paucity of studies exploring how clinical communication is taught and learned in audiology programs. Thus, the aims of the study were (a) to explore final year audiology students' perspectives of their own clinical communication skills during an in-house university clinical placement and (b) to explore students' perceptions of their clinical communication education.

Method

Using a qualitative description approach, students were asked to coview their filmed clinical encounter using video reflexivity during a semistructured interview on clinical communication education. Fifteen final year graduate audiology students from The University of Melbourne, Australia, participated in the study. The interviews were audio-recorded and analyzed thematically.

Results

The overarching themes of striving to be patient-centered, assessment shapes behavior, and power relations emerged from students' reflection of their own clinical encounter. In addition, the theme what students want described the perceived teaching methods that assisted students' clinical communication practices.

Conclusions

The findings of this study highlight the challenges that students perceived during their clinical placement as they strive to enact a patient-centered interaction. An assessment rubric that incorporates communication skills can provide greater opportunities for feedback and self-reflection. Additionally, clinical communication education that adopts experiential learning and is longitudinally integrated into the curriculum can further reinforce students' communication learning needs.

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Patient Acceptance of Invasive Treatments for Tinnitus

Purpose

The field of neuromodulation is currently seeking to treat a wide range of disorders with various types of invasive devices. In recent years, several preclinical trials and case reports in humans have been published on their potential for chronic tinnitus. However, studies to obtain insight into patients' willingness to undergo these treatments are scarce. The aim of this survey study was to find out whether tinnitus patients are willing to undergo invasive neuromodulation when taking its risks, costs, and potential benefits into account.

Method

A Visual Analog Scale (VAS, 0–10) was used to measure the outcome. Spearman's rank-order correlation coefficients were computed to determine the correlation between patient characteristics and acceptance rates.

Results

Around one fifth of the patients were reasonably willing to undergo invasive treatment (VAS 5–7), and around one fifth were fully willing to do so (VAS 8–10). Hearing aids, used as a control, were accepted most, followed by cochlear implantation, deep brain stimulation, and cortical stimulation. Acceptance rates were slightly higher when the chance of cure was higher. Patients with a history of attempted treatments were more eager than others to find a new treatment for tinnitus.

Conclusions

A considerable proportion of patients with tinnitus would accept a variety of invasive treatments despite the associated risks or costs. When clinical neuromodulatory studies for tinnitus are to be performed, particular attention should be given to obtaining informed consent, including explaining the potential risks and providing a realistic outcome expectation.

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