Search Results (406)

Hearing aids (HAs), especially those with sound generators (SGs), are used in the management of tinnitus. However, their comparative efficacies and long-term outcomes remain unknown. Therefore, we investigated the efficacy and long-term outcomes of tinnitus therapy using various HA SG models. We retrospectively reviewed 666 patients with chronic tinnitus characterized by persistent symptoms for >6 months. At the initial visit, the patients received educational counselling on tinnitus (Utsunomiya method) and completed a comprehensive questionnaire comprising the tinnitus handicap inventory, a visual analog scale, the state–trait anxiety inventory, and the emotional intelligence scale. The scores were compared among various models of HA SGs and SGs. The patients underwent follow-ups for up to 2 years. Our results indicated that tinnitus retraining therapy using SGs and conventional HAs effectively managed chronic tinnitus. The prolonged use of HAs appeared to exacerbate tinnitus symptoms, emphasizing the superior long-term effectiveness of SG HAs, particularly ZEN (Widex ZEN, WS Audiology, Lynge, Denmark). Our findings indicate that HAs are useful in the first year, but their prolonged use may exacerbate tinnitus symptoms, whereas HA SGs are effective in the long term. Future studies should account for the variations in tinnitus treatment effects based on the type of sound employed. Full article

Background: The aim of this study was to evaluate the performance of three disposable hearing aid battery brands available in Wales. Hearing-impaired individuals who utilise hearing aids rely on the functionality of their devices, which is often contingent upon the quality and longevity of disposable batteries. Materials and Methods: A grey literature review foregrounded the battery standards. The “real-life” use of batteries was supplemented through laboratory testing. Parameters relating to performance quality were used to quantify an overall service life of five PR44- and four PR48-size batteries per manufacturer. Results: The literature review signalled a large gap in hearing aid battery consumption research. All battery brands underperformed compared to their specifications but met IEC standards. Conclusions: Revisions to battery consumption test conditions should reflect new technological features and refine expectations of real-life use. It was possible to statistically identify the best performing hearing aid battery brand. Full article

Background: Cochlear implantation (CI) has proven to be a highly effective method for rehabilitating individuals with severe to profound hearing loss. However, challenges persist, particularly in cases where CI failure necessitates re-implantation. This study aims to address the gap in understanding the knowledge and practices of audiologists in the UK regarding cochlear re-implantation through a comprehensive questionnaire survey. Methods: A bespoke questionnaire was distributed to audiologists working with CI across the UK. The survey, which included multiple-choice items, open-text responses, and visual analogue scales, was made accessible via an online link shared through professional bodies, email groups, and social media platforms. Results: The survey received 27 responses, predominantly from female audiologists (71.4%), with significant representation from London (28.6%) and the East of England (21.4%). A majority of respondents had over 16 years of CI experience (35.7%) and held a master’s degree (60.7%). Key reasons for CI re-implantation included electrode failure (82.1%) and hermetic seal failure (60.7%). While respondents showed strong confidence in counselling (88.8%) and managing re-implanted devices (84.6%), there was a noted variation in opinions regarding the need for additional training in intraoperative measures. Conclusion: This survey highlights the current practices and training needs of UK audiologists in CI re-implantation. This underscores the importance of targeted training to fill knowledge gaps and improve clinical care during CI re-implantation, ultimately enhancing outcomes for both audiologists and CI recipients. Full article

Objective: This study’s objective was to identify the factors and impact of serums calcium 25-Hydroxy vitamin D, ferritin, uric acid, and sleeping disorders on benign paroxysmal positional vertigo (BPPV) patients. Methods: This is a case and control design study. The consecutive patients’ visits (age, older than 25 years) with idiopathic BPPV were recruited in the present study. For each patient, 3:1 sex and age-matched healthy people were assigned as the control. The study comprised 177 patients with BPPV and 656 controls. The study included biochemical, clinical, physical examinations, PSQI sleep quality, supine roll test, and Dix–Hallpike test for the diagnosis of all patients, and pure-tone audiometry (PTA) was used to assess hearing. Univariate and multivariate stepwise regression analyses were used for statistical analysis. Results: The study comprised 833 patients with 295 males (35.4%) and 538 females (64.6%) who were between 25 and 70 years old. Of a total of 833 participants, 177 were BPPV patients, and 656 subject were normal. The results shown that there were significant differences between the BPPV and the normal group in terms of BMI (p = 0.039), physical activity (p = 0.003), cigarette smoking (p = 0.035), nargile-waterpipe use (p < 0.001), diabetes (p < 0.001), hypertension (p < 0.001), congestive heart failure (CHF) (p < 0.001), neurology (p < 0.001), tinnitus (p < 0.001), dizziness (p < 0.001), headache (p < 0.001), vitamin D (p = 0.004), calcium (p = 0.004), magnesium (p < 0.001), potassium (p = 0.019), phosphorus (p < 0.001), haemoglobin (p < 0.001), serum glucose (p < 0.001), HbA1c (p < 0.001), triglyceride (p < 0.001), systolic BP (p = 0.004), diastolic BP (p = 0.008), and microalbuminuria (p = 0.005); ATP III metabolic syndrome (p = 0.038), IDF metabolic syndrome (p = 0.034), and poor sleep (p = 0.033). In terms of the type of BPPV, the posterior canal was the most commonly affected (n = 126, 71.2%), followed by the horizontal (n = 43, 24.3%) and anterior canal (n = 8, 4.5%). The analysis indicated that serum ferritin (p < 0.001), uric acid (p < 0.001), blood pressure (p < 0.001), dizziness (p < 0.001), cigarette–water-pipe smokers (p = 0.004), headaches/migraines (p = 0.005), calcium (p = 0.007), vitamin D deficiency (p = 0.008), sleepiness (p = 0.016), physical activity (p = 0.022), CHF (p = 0.024), and tinnitus (p = 0.025) were considered as risk predictors for BPPV. Conclusions: The results revealed that the serum levels of vitamin D, ferritin, uric acid, and calcium are low among the study population and supplementation could be considered as prevention in BPPV patients. Full article

Background: Identification of auditory processing disorders is achieved using questionnaires along with linguistic, non-linguistic, and auditory processing tests. Notably, the questionnaires “Children’s Auditory Performance Scale” (CHAPS) and “Auditory Processing Domain Questionnaire” (APDQ) are widely recognized and used. The current study investigated the psychometric properties of the CHAPS and APDQ in Greek Cypriot children. Methods: The CHAPS and APDQ questionnaires were completed by parents of 40 Greek Cypriot children, 16 typically developing (TD) children, and 24 children with a history of Speech Sound Disorders (SSDs). Results: There were significant differences between the two groups on both questionnaires. Cronbach’s alpha was calculated at α = 0.922 for the CHAPS total score and α = 0.926 for the APDQ total score. The Receiver Operating Curve (ROC) analysis provided a cut-off point equal to −0.30 (AUC 0.849, p < 0.001) for CHAPS and a cut-off point equal to 90.00 (AUC 0.820, p < 0.001) for APDQ. Significant positive Spearman ρ correlations were observed between the CHAPS and APDQ (ρ = 0.639, p = 0.001). Conclusions: The CHAPS and APDQ can identify distinct auditory processing characteristics between in children with SSDs and TD children. Full article

Background: A cochlear implant (CI) enables deaf people to understand speech but due to technical restrictions, users face great limitations in noisy conditions. Music training has been shown to augment shared auditory and cognitive neural networks for processing speech and music and to improve auditory–motor coupling, which benefits speech perception in noisy listening conditions. These are promising prerequisites for studying multi-modal neurologic music training (NMT) for speech-in-noise (SIN) perception in adult cochlear implant (CI) users. Furthermore, a better understanding of the neurophysiological correlates when performing working memory (WM) and SIN tasks after multi-modal music training with CI users may provide clinicians with a better understanding of optimal rehabilitation. Methods: Within 3 months, 81 post-lingual deafened adult CI recipients will undergo electrophysiological recordings and a four-week neurologic music therapy multi-modal training randomly assigned to one of three training focusses (pitch, rhythm, and timbre). Pre- and post-tests will analyze behavioral outcomes and apply a novel electrophysiological measurement approach that includes neural tracking to speech and alpha oscillation modulations to the sentence-final-word-identification-and-recall test (SWIR-EEG). Expected outcome: Short-term multi-modal music training will enhance WM and SIN performance in post-lingual deafened adult CI recipients and will be reflected in greater neural tracking and alpha oscillation modulations in prefrontal areas. Prospectively, outcomes could contribute to understanding the relationship between cognitive functioning and SIN besides the technical deficits of the CI. Targeted clinical application of music training for post-lingual deafened adult CI carriers to significantly improve SIN and positively impact the quality of life can be realized. Full article

Sensing gravity through the otolith receptors is crucial for bipedal stability and gait. The overall contribution of the otolith organs to eye movements, postural control, and perceptual functions is the basis for clinical testing of otolith function. With such a wide range of contributions, it is important to recognize that the functional outcomes of these tests may vary depending on the specific method employed to stimulate the hair cells. In this article, we review common methods used for clinical evaluation of otolith function and discuss how different aspects of physiology may affect the functional measurements in these tests. We compare the properties and performance of various clinical tests with an emphasis on the newly developed video ocular counter roll (vOCR), measurement of ocular torsion on fundus photography, and subjective visual vertical or horizontal (SVV/SVH) testing. Full article

Background: Enlarged vestibular aqueduct (EVA) syndrome can mimic otosclerosis in adults, presenting with an air–bone gap (ABG) and even absent stapedial reflexes. The ABG in inner-ear disorders is currently the object of several authors’ studies and seems to be related to a third mobile window (TMW) phenomenon. This can lead to misdiagnosis and inappropriate treatment. Given that it would be inappropriate and harmful to perform CT scans in all patients with a clinical diagnosis of otosclerosis, this study aims to highlight some clinical features useful for the differential diagnosis between otosclerosis and these rare cases of EVA presenting with an ABG, thus enabling the identification of suspected cases to be tested with CT scans. Methods: Between April and May 2024, a narrative review was conducted focusing on the differential diagnosis between some rare cases of EVA and otosclerosis. Clinical, audiological, and radiologic features of both conditions were investigated. Results: This review demonstrates the diagnostic challenge in differentiating atypical cases of EVA from otosclerosis in a subset of patients. Clinical and audiological features are important for differential diagnosis, but may not always be sufficient. Therefore, high-resolution computed tomography (HRCT) of the temporal bone plays a pivotal role in definitive diagnosis. Conclusions: In some specific cases, pre-operative imaging assessment using HRCT emerges as an essential tool for differentiating these two conditions and avoiding unnecessary stapes surgery. Full article

(1) Background: Cochlear implants (CIs) are widely applied to recover audition for patients with severe degrees of or total hearing loss. Electrical stimulation using the electrically evoked ABR (E-ABR) can be recorded in CI recipients through the device. This work was designed to study E-ABR recorded individually from different channels located at the apical, middle, and basal cochlear regions in comparison to their simultaneous separated or adjacent combined recordings. (2) Methods: This study included 17 children fitted with unilateral cochlear implants. All children were subjected to impedance measurement, electrical compound action potentials (ECAP), and E-ABR recording of three channels located at the apical, middle, and basal cochlear regions. This was followed by simultaneous E-ABR recording of the three “separated” channels in comparison to E-ABR recording from three adjacent channels located at the middle cochlear region. (3) Results: Similar E-ABR latencies and amplitudes were found using either individual or simultaneously separated or adjacent combined recording. However, the mean amplitude measures of E-ABR for combined adjacent channels showed a positive correlation with the applied current level. (4) Conclusions: Combined E-ABR recording from adjacent channels is a faster and more reliable technique that can be used effectively without compromising the results of the recorded E-ABR. Full article

Background: The aim of this study was to assess the neuromuscular control of adolescents with late unilateral cochlear implantation and compare them to adolescents with hearing aids (HAs) while performing a balance task on a platform with the conditions of an activated hearing device (cochlear implant (CI)/HAs) with eyes opened/closed (EO/EC). Methods: Forty-eight adolescents with hearing loss participated in the study and were divided into SG (unilateral CI and HA) and CG (bilateral HA). The evaluation of the postural stability was performed with a force plate during two repeating testing trials with EO/EC. Results: SG was characterized by greater values of vCOP compared to CG (EO), while, in CG, greater values of vCOP were noted in the second trial. The type of hearing device was found to be related to the values of area (EO) (p < 0.001), which were always greater in SG, regardless of the visual perception. Conclusions: Late unilateral CI may impact the activation of different models of the auditory compensatory mechanism than HA, which is related to neuromuscular control. The values of vCOP can be predicted by age in late-CI individuals. Visual perception seems not to be related to the values of the area, which can be impacted both by CI and HA. Full article

Nystagmus induced by applying an intense vibratory stimulus to the skull (SVIN) indicates vestibular functional asymmetry. In unilateral vestibular loss, a 100 Hz bone-conducted vibration given to either mastoid immediately causes a primarily horizontal nystagmus. The test is performed in darkness to avoid visual fixation (VF) but there are no data about how much VF affects the often-intense SVIN. The aim is to analyze the amount of reduction in SVIN when VF is allowed during testing. Thus, all patients seen in a tertiary hospital for vertigo or dizziness with positive SVIN were included. SVIN was recorded for 10 s for each condition: without VF (aSVINwo) and with VF (aSVINw). We obtained an aSVINwo and an aSVINw as average slow-phase velocities (SPV) without and with VF. VF index (FI_SVIN) was calculated as the ratio of SPV. Among the 124 patients included, spontaneous nystagmus (SN) was found in 25% and the median slow phase velocity (mSPV) (without VF) of SN was 2.6 ± 2.4°/s. Mean FI_SVIN was 0.27 ± 0.29. FI_SVIN was 0 in 42 patients, and FI_SVIN between 0 and 1 was found in 82 (mean FI_SVIN 0.39 ± 0.02). Fixation suppression was found in all patients with SVIN in cases of peripheral vestibulopathy. FI_SVIN clearly delineates two populations of patients: with or without a complete visual reduction in nystagmus. Full article

Purpose: The purpose of this study was to evaluate the efficacy of auditory training (AT) in patients with unilateral hearing loss (UHL) using hearing aids (HAs), comparing traditional methods with a new approach involving a wireless remote microphone. Methods: The study included 96 participants, divided into two groups, with ages ranging from 42 to 64 years, comprising both male and female subjects. A clinical trial including consecutive moderate UHL patients was performed at our institution. For the study group, a Roger Pen was used during AT with patients inside a sound-attenuating cabin. Controls followed conventional sessions. Professional speech and language pathologists performed the rehabilitation. Audiological outcomes were measured, including word recognition at signal-to-noise ratios (SNRs) of 0 dB, +5 dB, and +10 dB, to determine the effectiveness of the training. Measurements also included the Speech, Spatial, and Qualities of Hearing Scale to assess perceived auditory abilities. Results: A total of 46 and 50 UHL patients were randomly included in the study and control groups, respectively. No differences were found in terms of sex, age, presence of tinnitus, duration of hearing loss, pure tone average, and speech-in-noise perception without an HA. Following HA fitting and AT, a notable enhancement in the ability to identify speech in noisy environments was observed in the study group. This improvement was significant at SNRs of +5 and +10. When comparing the ability to identify speech in noise using HAs across both groups, it was observed that hearing capabilities post-wireless AT showed a significant improvement at an SNR of +5. Only the study group had a significant improvement in the total Speech, Spatial, and Qualities of Hearing Scale score after the training. Conclusions: In our group of UHL patients, we found significantly better speech-in-noise perception when HA fitting was followed by wireless AT. Wireless AT may facilitate usage of HAs, leading to binaural hearing in UHL patients. Our findings suggest that future interventions might benefit from incorporating wireless technology in AT programs. Full article

The COVID-19 pandemic dramatically changed health service delivery with vulnerable patients advised to isolate and appointments provided virtually. This change affected recruitment into an observational cohort study, undertaken at a single site, where participants with mitochondrial disorders were due to have specialist hospital-based audiovestibular tests. To ensure study viability, the study protocol was amended to allow home-based assessment for vulnerable participants. Here, we report outcomes of an online survey of participants who underwent home-based assessment, related to the experience, perceived benefits, and drawbacks of home audiovestibular assessments. Seventeen participants underwent home-based neuro-otological assessment, due to the need to isolate during COVID-19. Following the assessment, 16 out of 17 participants completed an anonymised online survey to share their experiences of the specialist home-based assessment. One hundred percent of participants rated the home-based assessment ‘very positively’ and would recommend it to others. Sixty-three percent rated it better than attending hospital outpatient testing settings. The benefits included no travel burden (27%) and reduced stress (13%). A majority reported no drawbacks in having the home visit. The patient-reported feedback suggests a person-centred approach where audiovestibular assessments are conducted in their homes is feasible for patients, acceptable and seen as beneficial to a vulnerable group of patients. Full article

Bipedalism is unique among mammals. Until modern times, a fall and resulting leg fracture could be fatal. Balance maintenance after a destabilizing event requires instantaneous decision making. The vestibular system plays an essential role in this process, initiating an emergency response. The afferent otolithic neural response is the first directionally oriented information to reach the cortex, and it can then be used to initiate an appropriate protective response. Some vestibular efferent axons feed directly into type I vestibular hair cells. This allows for rapid vestibular feedback via the striated organelle (STO), which has been largely ignored in most texts. We propose that this structure is essential in emergency fall prevention, and also that the system of sensory detection and resultant motor response works by having efferent movement information simultaneously transmitted to the maculae with the movement commands. This results in the otolithic membrane positioning itself precisely for the planned movement, and any error is due to an unexpected external cause. Error is fed back via the vestibular afferent system. The efferent system causes macular otolithic membrane movement through the STO, which occurs simultaneously with the initiating motor command. As a result, no vestibular afferent activity occurs unless an error must be dealt with. Full article

Congenital hearing loss is a significant global health concern that affects millions of newborns and infants worldwide, posing substantial challenges for affected individuals, their families, and healthcare systems. This condition, present at birth, can stem from genetic factors, in utero exposures, infections, or complications during pregnancy or childbirth. The spectrum of congenital hearing loss ranges from mild to profound, impacting the development of speech, language, and cognitive skills, thereby influencing educational achievements, social integration, and future employment opportunities. Early detection and intervention strategies, such as newborn hearing screenings, genetic counseling, and the use of hearing aids or cochlear implants, are crucial for mitigating these impacts. This review article aims to explore the diagnostic approaches and management strategies for congenital cytomegalovirus-related hearing loss, emphasizing the importance of interdisciplinary care and the potential for technological advances to improve outcomes for affected individuals. Full article