Internet-Based Hearing Assessment During COVID era in Indian Population: Practical and Safe Option
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Internet-Based Hearing Assessment During COVID era in Indian Population: Practical and Safe Option Pranav Mishra1 • Angira Katyayan2 • Adri Katyayan3 • Anupam Mishra1
Received: 19 August 2020 / Accepted: 3 October 2020 Association of Otolaryngologists of India 2020
Abstract This pilot observation intends to stress on webbased hearing assessment (WBHA) as somewhat parallel to clinical pure tone audiometry. While WBHA was comparable with PTA in context of severity of deafness particularly in symmetrical hearing loss, it was inconclusive for a gross asymmetry despite multiple trials. With increasing COVID transmission, more need for social distancing and lack of audiologists in developing countries, the self-participation by patients in WBHA model will prove to be a very safe model of deafness-screening. Keywords Audiometry Internet Deafness
The social proximity particularly in a closed cabin such as audiological suit portends a risk for COVID disease transmission. Hence in accordance with social distancing, tele-assessment of hearing functions are to be preferred wherever necessary. This context is particularly applicable for rural sectors of developing world with a higher prevalence of hearing loss. A WHO study1 conducted by our team, revealed a prevalence of 15% deafness in general rural population across Lucknow district (India) that is in turn grossly mismanaged owing to a substandard health care2 and patient–doctor ratio. COVID-19 has altered the & Anupam Mishra [email protected] 1
King George Medical University, Lucknow, Uttar Pradesh 226003, India
2
Indian Institute of Technology (IIT), Kanpur, Uttar Pradesh 208016, India
3
City Montessori School, Mahanagar, Lucknow, Uttar Pradesh 226006, India
existing paradigm in hearing assessment techniques and will further worsen the deafness in densely populated third world. Hence there is a dire need to at least screen out the potential hearing impaired in general population with absolutely safe and reliable methods. This commentary highlights a pilot study intended for screening hearing using internet that can be safely applied to this COVID situation. Considering the least expensive internet services available in India (across the globe), this pilot work supports ‘internet-based hearing assessment model’ to screen the targeted population even by non-medical persons and thereby also overcoming geographical barriers. Several such online programs are freely available particularly linked with sale of hearing aids. Through observer ship program of undergraduate and high school students in a tertiary hospital (after due permission from Chief Medical Superintendent of Hospital), a basic comparison of subjective (air conduction) responses from pure tone audiometry (PTA) and online web-based hearing assessment (WBHA) was undertaken. The latter consisted of a simple earphone connected to a laptop with Internet that generated similar pure tones across 6 speech frequencies as PTA. Twenty patients of hearing loss were assessed both by PTA and WBH
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