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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. [ABSTRACT FROM AUTHOR]

Introduction. In the Netherlands, there is considerable political pressure to reduce the costs for hearing aids. In particular, the added value of the fitting of two hearing aids is questioned and the reimbursement of the second hearing aid may be limited in the near future. A broad study design was initiated in 10 audiological centres (co-operating in the Platform for Audiological Clinical Testing, PACT) to investigate the added value of the second hearing aid. Methods. Current practice in the Netherlands has been determined with a questionnaire among clinical audiologists in most of the Audiological Centres. In addition, a retrospective analysis of 1000 cases in eight audiological centres was performed and fitting results were combined with audiometric data. An extensive questionnaire about the use and benefit of one or two hearing aids was developed and was sent to the same subjects included in the retrospective study mentioned above. Results. The data allow a detailed insight into current practice and the use and subjective benefit experienced by a large body of hearing aid users. Conclusion. It proves to be difficult to base a new criterion for reimbursement on standard audiometric data alone. Therefore, additional work is planned in the development of a priori tests with a high predictive value for the benefit of binaural hearing aid fitting and more detailed performance measures to evaluate the results obtained with one or two hearing aids. [ABSTRACT FROM AUTHOR]

Introduction. As part of a national study on the practice and effectiveness of binaural hearing aid fitting, we developed two sets of tests. The first set of tests, using headphones, is a diagnostic tool and aims at measuring hearing abilities that are needed to obtain benefit from a binaural hearing aid. The second set of tests, using loudspeakers, aims at an evaluation of the obtained benefit in speech perception and localization in everyday conditions. Methods. Tests were conducted with candidates for binaural hearing aid fitting. Prognostic tests included binaural masking level difference, detection of interaural time delay, detection of a spectral notch and the precedence effect. The evaluation was performed with tests on speech reception with modulated noise or several interfering talkers in different configurations. Additionally, the hearing aid benefit was evaluated with a dedicated questionnaire measuring subjective improvement in auditory performance. Results. Thus far, the tests have been completed for 13 patients; only one of them eventually preferred a monaural hearing aid. Results on the evaluation tests are in accordance with the results of the questionnaire. The number of patients is still too low to establish the value of prognostic tests. Larger numbers will be available at the meeting. [ABSTRACT FROM AUTHOR]