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This scoping review investigated key findings about hearing loss (HL) in the working life (WL) from a well-being perspective. A scoping review protocol was used to search the literature and to explore and extract key findings. A narrative analysis of key findings was used to group the data into themes. Study sample: Fifty-three articles from 29 different journals were included in the analysis. The narrative analysis identified three broad themes; individual aspects, work environment and work organisation. Individual aspects concerned problems that workers with HL experienced in their working lives, strategies they used to manage their working lives and different aspects of health in relation to WL. Work environment focussed on the physical, organisational and social work environment. Work organisation identified aspects related to division of labour and employment status. Several of the included papers revealed lots of findings but did not substantially discuss the findings from a WL perspective. HL and well-being in WL is a multidimensional phenomenon due to the interplay between the individual and the environment. This interplay is rarely discussed in the included papers. Furthermore, intersectional aspects are infrequently highlighted and need to be further explored in future research. [ABSTRACT FROM AUTHOR]

Systematically review the current literature for evidence on the "real-life" benefits of hearing preservation cochlear implantation (HPCI) for children and adults. Systematic search of Pubmed, MEDLINE, EMBASE, CINHAL and Cochrane Library for MesH terms hearing¸ preservation and cochlear implantation. Inclusion criteria were the "real-life" benefit of HPCI i.e. other than pre- and post-operative pure tone thresholds. Exclusion criteria were non-English language, conference abstracts, reviews and animal and cadaveric studies. Risk of bias was assessed using the Evidence Project Tool. 37 studies that matched criteria for review with 8/37 including children and 29/37 including adults. HPCI was associated with better speech perception in noise in 18/26 papers and better music perception in 4/5 papers. There was no significant benefit reported in speech perception in quiet (14/20 papers) or binaural cues (3/4 papers), nor was there convincing evidence of HPCI outperforming bimodal users (5/7 papers). QoL scores were high amongst HPCI patients (2/2 papers). Interpretation of findings was hindered by small study groups and significant heterogeneity in various parameters. Current literature on the "real-life" benefit of HPCI, although limited, supports the existence of meaningful benefit, especially in speech perception in noise and music perception. [ABSTRACT FROM AUTHOR]

Hyperacusis is known as a reduced tolerance to sounds perceived as normal to the majority of the population. There is currently no agreed definition, diagnostic tool, or objective measure of its occurrence. The purpose of this review is to catalogue the research to date on the use of auditory evoked potentials (AEP) to assess hyperacusis. A step-by-step methodology was conducted following guidelines. Four databases were searched. A total of 3343 papers were identified. A final yield of 35 articles were retained for analysis. The analysis identified four types of aetiologies to describe the hyperacusic population in AEP studies; developmental disorders (n = 19), neurological disorders (n = 3), induced hearing damage (n = 8) and idiopathic aetiology (n = 5). Electrophysiological measures were of short (n = 16), middle (n = 13) and long (n = 19) latencies, believed to reflect the activity of the ascending and descending pathways of the auditory system from periphery to cortex. The results of this review revealed the potential use of electrophysiological measures for further understanding the mechanisms of hyperacusis. However, according to the disparity of concepts to define hyperacusis, definitions and populations need to be clarified before biomarkers specific to hyperacusis can be identified. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review and critically appraise the literature describing the phonetic characteristics and accuracy of the consonants, vowels and tones produced by Mandarin-speaking children with cochlear implants (CIs). The protocol in this review was designed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. EBSCOhost, PubMed, Scopus, PsycINFO, ProQuest Central databases were searched for relevant articles which met the inclusion criteria. A total of 18 journal papers were included in this review. The results revealed that Mandarin-speaking children with CIs perform consistently more poorly in their production of consonants, in particular on fricatives, have a smaller and less well-defined vowel space, and exhibit greater difficulties in tone realisation, notably T2 and T3, when compared to their normal-hearing (NH) peers. The results from acoustic and accuracy analyses are negatively correlated with CI implantation age, but largely positively correlated with hearing age. Findings of this review highlight the factors that influence consonant, vowel and tone production in Mandarin-speaking children with CIs, thereby providing critical information for clinicians and researchers working with this population. [ABSTRACT FROM AUTHOR]

This review article presents an overview of all Digit Triplet Tests (DTT) and digits-in-noise tests (DIN) and their variations in language, speech material, masking noise, test procedures, and targeted population. The effects on aspects of validity, reliability, and feasibility are investigated. Scoping review. All studies referring to the DTT and DIN were collected from Pubmed and Embase. Search terms "digit triplet test" and "digits in noise" were used. Citations of selected articles were scanned backwards in time (the bibliography of the already selected research article) and forward in time (articles that cited the already selected research article). The search terms yielded 95 results in total. Eventually, 39 papers were selected. Analyses showed psychometric reference-curves with steep slopes and speech reception thresholds with high measurement precision which are strongly associated with pure tone audiometry. High sensitivity and specificity to detect elevated pure tone thresholds were noted for test variants. Certain procedural modifications of the DTT and DIN can further improve the test. Additionally, large-scale application of the DTT and DIN is feasible. The DTT and DIN are a very valuable tool for screening and diagnostics for a wide variety of populations. [ABSTRACT FROM AUTHOR]

Objective: This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Design: Literature review and synthesis. Study sample: Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Results: Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. Conclusion: This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice. [ABSTRACT FROM AUTHOR]

Objective:Acquired hearing impairment is recognized by the World Health Organization as the third leading cause of disability, with a mild impairment being the most prevalent. The aim of this study was to review research literature concerned with adults with acquired mild hearing impairment; the definitions and prevalence, the resulting activity limitations and participation restrictions, and hearing-aid interventions.Design:This study involved a systematized review of research literature identified through searches in citation databases and through reference checking.Study sample:A total of 151 papers were identified and of these, 33 papers were included in this review.Results:Prevalence rates are significantly influenced by the definition used for mild hearing impairment, and range from 1 in 3 to 1 in 5 adults. The weak correlations between audiological assessments and self-reported difficulties suggest that further assessment of individuals with mild hearing impairment is warranted. The most common intervention is the provision of hearing aids with varying rates of use, benefit, and satisfaction.Conclusions:The development of appropriate audiological assessment in the clinic, and further evaluation of the real-world listening needs and performance of people with mild hearing impairment is required to provide a more effective pathway for this clinical population. [ABSTRACT FROM PUBLISHER]

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Objective: To examine the psychosocial experiences of hearing loss from the perspectives of both the person with hearing loss and their communication partner. Design: A meta-synthesis of the qualitative literature. Study Sample: From 880 records, 12 qualitative papers met the inclusion criteria, (i) adults with hearing loss, communication partners, or both, and (ii) explored psychosocial issues. Results: Four themes related to the psychosocial experience of hearing loss were found, (i) the effect of the hearing loss, (ii) the response to hearing aids, (iii) stigma and identity, and (iv) coping strategies. Hearing loss affected both people with hearing loss and communication partners. Hearing aids resulted in positive effects, however, these were often outnumbered by negative effects. Non-use of hearing aids was often influenced by stigma. Coping strategies used were related to how the person with hearing loss perceived their self and how the communication partner perceived the relationship. Aligned coping strategies appeared to have a positive effect. Conclusions: Hearing loss affects both people with hearing loss and their communication partners. Aligned coping strategies can facilitate adjustment to hearing loss. [ABSTRACT FROM AUTHOR]

Objectives: Otitis media with effusion (OME) is the presence of non-purulent inflammation in the middle ear. Hearing impairment is frequently associated with OME. Pure tone audiometry and speech audiometry are two of the most primarily utilised auditory assessments and provide valuable behavioural and functional estimation on hearing loss. This paper was designed to review and analyse the effects of the presence of OME on children's listening abilities. Design: A systematic and descriptive review. Study sample: Twelve articles reporting frequency-specific pure tone thresholds and/or speech perception measures in children with OME were identified using PubMed, Ovid, Web of Science, ProQuest and Google Scholar search platforms. Results: The hearing loss related to OME averages 18-35 dB HL. The air conduction configuration is roughly flat with a slight elevation at 2000 Hz and a nadir at 8000 Hz. Both speech-in-quiet and speech-in-noise perception have been found to be impaired. Conclusions: OME imposes a series of disadvantages on hearing sensitivity and speech perception in children. Further studies investigating the full range of frequency-specific pure tone thresholds, and that adopt standardised speech test materials are advocated to evaluate hearing related disabilities with greater comprehensiveness, comparability and enhanced consideration of their real life implications. [ABSTRACT FROM AUTHOR]

Objective: Drug-mediated ototoxicity, specifically cochleotoxicity, is a concern for patients receiving medications for the treatment of serious illness. A number of classification schemes exist, most of which are based on pure-tone audiometry, in order to assist non-audiological/non-otological specialists in the identification and monitoring of iatrogenic hearing loss. This review identifies the primary classification systems used in cochleototoxicity monitoring. By bringing together classifications published in discipline-specific literature, the paper aims to increase awareness of their relative strengths and limitations in the assessment and monitoring of ototoxic hearing loss and to indicate how future classification systems may improve upon the status-quo.Design: Literature review.Study sample: PubMed identified 4878 articles containing the search term ototox*.Results: A systematic search identified 13 key classification systems. Cochleotoxicity classification systems can be divided into those which focus on hearing change from a baseline audiogram and those that focus on the functional impact of the hearing loss.Conclusions: Common weaknesses of these grading scales included a lack of sensitivity to small adverse changes in hearing thresholds, a lack of high-frequency audiometry (>8 kHz), and lack of indication of which changes are likely to be clinically significant for communication and quality of life. [ABSTRACT FROM PUBLISHER]

Abstract Objective: Adult hearing screening may be a solution to the under-diagnosis and under-treatment of hearing loss in adults. Limited use and satisfaction with hearing aids indicate that consideration of alternative interventions following hearing screening may be needed. The primary aim of this study is to provide an overview of all intervention types that have been offered to adult (≥ 18 years) screen-failures. Design: Systematic literature review. Articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, private libraries, and through reference checking. Results: Of the initial 3027 papers obtained from the searches, a total of 37 were found to be eligible. The great majority of the screening programmes (i.e. 26) referred screen-failures to a hearing specialist without further rehabilitation being specified. Most of the others (i.e. seven) led to the provision of hearing aids. Four studies offered alternative interventions comprising communication programme elements (e.g. speechreading, hearing tactics) or advice on environmental aids. Conclusions: Interventions following hearing screening generally comprised referral to a hearing specialist or hearing aid rehabilitation. Some programmes offered alternative rehabilitation options. These may be valuable as an addition to or replacement of hearing aid rehabilitation. It is recommended that this be addressed in future research. Sumario Objetivo: El tamiz auditivo en adultos puede ser una solución al diagnóstico y tratamiento insuficiente de las alteraciones auditivas en adultos. El uso y satisfacción limitados con los auxiliares auditivos indica que pueden necesitarse intervenciones alternativas luego del tamiz auditivo. El propósito primario de este estudios es echar un vistazo a todos los tipos de intervención que han sido ofrecidas a adultos (≥ 18 años) que fallan dicho tamiz. Diseño: Revisión sistemática de la literatura. Se identificaron artículos a través de una búsqueda sistemática en PubMed, EMBASE, Cinahl, la Biblioteca Cochran, bibliotecas privadas y a través de revisión de referencias. Resultados: De los 3027 trabajos iniciales obtenidos de las búsquedas, se encontró un total de 37 que eran elegibles. La gran mayoría de los programas de tamiz auditivo (p.e., 26) refirieron los fallos del tamiz a un especialista en audición, sin especificar nada adicional sobre rehabilitación. La mayoría de los otros (p.e., 7) llevaron a la adaptación de auxiliares auditivos. Cuatro estudios ofrecieron intervenciones alternativas que involucraban programas de comunicación (p.e., lectura labio-facial, tácticas para escuchar) o consejo sobre ayudas ambientales. Conclusiones: Las intervenciones que siguez al tamiz auditivo involucraron referencia a especialistas en audición o rehabilitación con auxiliares auditivos. Algunos programas ofrecieron opciones alternativas de rehabilitación. Estos pueden ser valiosos como una adición o en reemplazo de la rehabilitación con auxiliares auditivos. Se recomienda que esto sea analizado en investigaciones futuras. [ABSTRACT FROM AUTHOR]

Remote hearing screening and assessment may improve access to, and uptake of, hearing care. This review, the most comprehensive to date, aimed to (i) identify and assess functionality of remote hearing assessment tools on smartphones and online platforms, (ii) determine if assessed tools were also evaluated in peer-reviewed publications and (iii) report accuracy of existing validation data. Protocol was registered in INPLASY and reported according to PRISMA-Extension for Scoping Reviews. In total, 187 remote hearing assessment tools (using tones, speech, self-report or a combination) and 101 validation studies met the inclusion criteria. Quality, functionality, bias and applicability of each app were assessed by at least two authors. Assessed tools showed considerable variability in functionality. Twenty-two (12%) tools were peer-reviewed and 14 had acceptable functionality. The validation results and their quality varied greatly, largely depending on the category of the tool. The accuracy and reliability of most tools are unknown. Tone-producing tools provide approximate hearing thresholds but have calibration and background noise issues. Speech and self-report tools are less affected by these issues but mostly do not provide an estimated pure tone audiogram. Predicting audiograms using filtered language-independent materials could be a universal solution. [ABSTRACT FROM AUTHOR]

Hearing aids are typically programmed using the individual's audiometric thresholds and verified using real-ear measures. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not necessarily programmed using the individual's audiometric thresholds. This review aimed to identify whether programming hearing aids using the individual's validated audiogram-based prescription, and verified using real-ear measures, results in better outcomes for adults with hearing loss. The review was registered in PROSPERO and reported in accordance with PRISMA guidelines. After screening more than 1370 records, seven experimental studies met the eligibility criteria. Studies were categorised under three methods of fitting: (i) comparative fitting evaluating different settings based on the beliefs of the audiologist; (ii) client choice of preset responses; and (iii) self-fit by adjustment. The findings suggest that using a prescription based on the individual's audiogram improves outcomes relative to the comparative and client choice fitting approaches. Self-adjustment during daily use may produce equivalent (or better) outcomes than an audiogram-based prescription. The quality of evidence for the outcomes ranged from low to very low. This review has highlighted the dearth of high-quality studies on which to make evidence-based decisions on hearing aid fitting methods. [ABSTRACT FROM AUTHOR]

Whether hearing aid use in older adults modifies speech perception over time is not clear. To address this question, we systematically reviewed studies in which older first-time hearing aid users and controls were followed over time. The review was pre-registered in PROSPERO and performed in accordance with the statement on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The question, inclusion and exclusion criteria were defined using the Population, Intervention, Control, Outcomes and Study design (PICOS) framework. Studies with no controls, studies in which participants and controls were tested at only one-time point, with no follow-up and no pre-fitting measures, or when outcome measures did not include speech measures, were excluded. 6113 studies were screened, out of which 12 studies, published between 1996 and 2021, met the inclusion and exclusion criteria and were included in the final review. 9 of the 12 studies found evidence for amplification-induced auditory plasticity in older adults, expressed in improved speech perception. The results suggest amplification-induced improvements in speech perception over time, but findings should be interpreted with caution because overall improvements were small, and the studies' quality was moderate. [ABSTRACT FROM AUTHOR]

As tinnitus is often associated with hearing loss, hearing aids have been proposed for tinnitus relief in literature for more than 70 years. There is a need for recent literature to be reviewed and guide decision making in tinnitus management. This scoping review aims to provide an update of the available evidence on hearing aids for tinnitus, focussing on the effect of sound amplification or combination devices (i.e. amplification and sound generation within one device). Research studies were included if they investigated hearing aids or combination devices for tinnitus and were published after 2011. A total of 28 primary research studies were selected. Positive results of hearing aids in tinnitus patients were shown in 68% of the studies, whereas 14% demonstrated no change in tinnitus distress. However, the quality of the evidence across studies was variable. Scientific support for hearing aids and combination devices for tinnitus relief was found. The standalone effect of sound amplification and the added value of sound generators and adjustment of sound processing strategies needs further investigation. Stronger methodology in future studies is needed to reach consensus on how to optimise hearing solutions in a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

To systematically review the peer-reviewed literature on the efficacy of auditory training (AT) on auditory outcomes in post lingually deafened adults with cochlear implants (CIs). A systematic review. Searches of five electronic databases yielded 10 studies published after 2010 that met the inclusion criteria. For post lingually deafened adults with CIs, the evidence is suggestive that some AT can improve some auditory outcomes compared to no training. More specifically, the evidence suggests that phonemic training can improve identification of trained phonemes, and nonsense word training can improve sentence recognition in noise in this population. While many AT interventions are currently being used with post lingually deafened adults with CIs, the evidence for AT improving auditory outcomes is suggestive with the best evidence being for nonsense word training improving sentence recognition in noise by an average of 10% with these improvements retained at 26 weeks post-training in this population. There remains a need for high quality studies that have the capacity to demonstrate, clearly and unequivocally, which AT is most effective for improving which auditory outcomes in this population. [ABSTRACT FROM AUTHOR]

Objective:To systematically review the relevant peer-review literature investigating the outcome of simulated learning environment (SLE) training in audiology education.Design:A systematic review research design.Study sample:Fifteen databases were searched with four studies meeting the inclusion criteria.Results:Three of the four studies revealed positive findings for the use of an SLE (that is, the SLE group showed a higher post-training score compared to the traditional training group or a significantly higher post-training score than the non-training groups). One study revealed negative findings where the traditional training group showed a significantly higher post-training score than the SLE group. In addition, both the studies comparing post- and pre-training scores reported significantly higher post-training scores than the pre-training scores of the participants that underwent SLE training.Conclusions:Overall, this review supports the notions that SLE training is an effective learning tool and can be used for basic clinical training. This conclusion should be treated with caution, considering the limited numbers of studies published in this area and future research should be conducted to cope with the gaps highlighted in this review. [ABSTRACT FROM PUBLISHER]

Telecommunication can be difficult in the presence of noise or hearing loss. The purpose of this study was to systematically review evidence regarding the effects of text supplementation (e.g. captions, subtitles) of auditory or auditory-visual signals on speech intelligibility for listeners with normal or impaired hearing. Three databases were searched. Articles were evaluated for inclusion based on the Population Intervention Comparison Outcome framework. The Effective Public Health Practice Project instrument was used to evaluate the quality of the identified articles. After duplicates were removed, the titles and abstracts of 2019 articles were screened. Forty-six full texts were reviewed; ten met inclusion criteria. The quality of all ten articles was moderate or strong. The articles demonstrated that text added to auditory (or auditory-visual) signals improved speech intelligibility and that the benefits were largest when auditory signal integrity was low, accuracy of the text was high, and the auditory signal and text were synchronous. Age and hearing loss did not affect benefits from the addition of text. Although only based on ten studies, these data support the use of text as a supplement during telecommunication, such as while watching television or during telehealth appointments. [ABSTRACT FROM AUTHOR]

Social isolation and loneliness are interrelated but independent constructs that threaten healthy aging and well-being and are thought to be associated with hearing loss. Our aim was to review the empirical studies that have examined the association between hearing loss and social isolation and/or loneliness to highlight future research needs. Scoping review. Three electronic databases were searched combining key terms of "hearing loss", "hearing impairment" and "deaf*" with "social isolation" or "loneliness", yielding an initial result of 939 articles. After removing duplicate articles, abstract screening and full-text review, 57 original articles met our inclusion criteria. Studies were diverse in terms of methodology with the most common type of study being studies that have explored the relationship between hearing loss and social isolation/loneliness from large population-based datasets. Only eight studies were intervention studies and of these, only one specifically explored the outcomes of hearing aids (HAs) on social isolation/loneliness. Further research is warranted to examine the influence that hearing interventions, in particular HAs, have on social isolation and/or loneliness, with a specific need to include people who identify as being socially isolated and/or lonely at baseline. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the effect of cochlear implantation (CI) in advanced Ménière's disease (MD). Design: The initial search on PubMed, EMBASE, and Cochrane databases yielded 171 articles; no language restriction was applied. Study sample: A total of 11 articles met the inclusion criteria and were included in this systematic review. Six articles provided patient-level data on improvement in speech recognition testing after CI. Results: The methodological quality of included studies was assessed by examining the study design, level of evidence, method of measurement and adequacy of outcome reporting. A random-effect model was fitted for calculating weighted means. Post-operative improvement in word recognition score (WCS) was 50.8% (95% confidence interval: 34.6–67.1%); general improvement of vestibular symptoms after CI was found in 67% of the pooled patients; when reported in the studies, quality of life (QoL) and tinnitus were also generally improved after CI. Conclusions: CI in advanced MD is a valid option providing good outcomes in terms of speech performances, regardless of the disease duration, uni- or bilaterality, age at implantation, previous therapeutic procedures and stage of activity of MD. [ABSTRACT FROM AUTHOR]

Objective: This article presents a comprehensive literature review of past works addressing Hearing Protection Devices (HPD) comfort and to put them into perspective regarding a proposed holistic multidimensional construct of HPD comfort. Design: Literature review. Study samples: Documents were hand searched and Internet searched using "PubMed", "Web of Science", "Google Scholar", "ProQuest Dissertations and Theses Professional", "Scopus" or "Google" search engines. While comfort constructs and measurement methods are reviewed for both earplugs and earmuff types, results and analyses are provided for the earplug type only. Results: This article proposed a multidimensional construct of HPD comfort based on four dimensions: physical, functional, acoustical and psychological. Seen through the prism of the proposed holistic construct of HPD comfort, the main comfort attributes of earplugs have been identified for each comfort dimension. Conclusions: The observed lack of consensus on the definition of HPD comfort in the scientific community makes it difficult to prioritise the importance of comfort attributes yet necessary for future design of comfortable earplugs. [ABSTRACT FROM AUTHOR]

Objective: Universal newborn hearing screening (UNHS) uses otoacoustic emissions testing (OAE) and auditory brainstem response testing (ABR) to screen all newborn infants for hearing loss (HL), but may not identify infants with mild HL at birth or delayed onset HL. The purpose of this review is to examine the role of genetic screening to diagnose children with pre-lingual HL that is not detected at birth by determining the rate of children who pass UNHS but have a positive genetic screening. This includes a summary of the current UNHS and its limitations and a review of genetic mutations and screening technologies used to detect patients with an increased risk of undiagnosed pre-lingual HL. Design: Literature review of studies that compare UNHS with concurrent genetic screening. Study sample: Infants and children with HL Results: Sixteen studies were included encompassing 137,895 infants. Pathogenic mutations were detected in 8.66% of patients. In total, 545 patients passed the UNHS but had a positive genetic screening. The average percentage of patients who passed UNHS but had a positive genetic screening was 1.4%. Conclusions: This review demonstrates the positive impact of concurrent genetic screening with UNHS to identify patients with pre-lingual HL. [ABSTRACT FROM AUTHOR]

Objective: To identify any change in quality of life (QoL) caused by chemotherapy-induced toxicities, such as hearing loss and tinnitus, to provide information in order to improve services and aid clinicians in their decision-making. Design: This systematic review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. The search terms were cancer, platinum-based chemotherapy, ototoxicity and "quality of life". Titles and abstracts, followed by full texts, were screened by two independent researchers. The relevant data were extracted and quality analysis was performed using the NIH Quality Assessment Tool. Study sample: About 308 titles and abstracts were screened, and 27 full-text articles were screened. Ten articles representing 11 studies were included in the review. Study design included cross-sectional studies, randomised control trials and longitudinal studies. Results: Diagnostic criteria consisted of audiograms, questionnaires and patient complaints. The study quality ranged from 21.43% to 85.71%. Overall results found that those treated with cisplatin had more hearing loss and tinnitus than those treated with other therapies. Furthermore, those with hearing loss and tinnitus were more likely to have a lower QoL. Conclusions: There is an urgent need to standardise diagnostics when investigating ototoxicity and its effect on QoL, particularly for research into risk factors, prevention and management. [ABSTRACT FROM AUTHOR]

Objective: Determine whether a combination of electrocochleography determined summating/action potential (SP/AP) ratio and other audiological measurements has greater sensitivity and specificity than that achieved with electrocochleography SP/AP ratio alone in diagnosing definite Ménière's Disease. Design: Systematic review and meta-analysis. Study sample: Pubmed, Cochrane Library, and Web of Science were searched using search terms "electrocochleography", "ECochG, ,"ECoG", "Ménière's Disease", and "Idiopathic Endolymphatic Hydrops". Inclusion criteria were extratympanic electrocochleography methodology, English language publication between January 2002 and December 2017, and the 1995 American Academy of Otolaryngology and Head and Neck Surgery Ménière's disease diagnostic criteria. Five articles satisfied inclusion criteria and were sufficiently detailed for aggregate quantitative analysis of SP/AP ratio (315 subjects) and combination audiological measures (113 subjects). Results: The diagnostic sensitivity and specificity of the SP/AP amplitude ratio was 47.6% and 83.8% and of combination diagnostic measures 63.5% and 89.3%, respectively. Point estimates of sensitivity (p = 0.248) and specificity (p = 0.969) and the summary Receiver Operator Characteristic Curve (p = 0.407) were not statistically significant. Conclusion: Statistically, combination diagnostic measures do not result in greater accuracy of definite Ménière's disease diagnosis compared to the SP/AP amplitude ratio alone. However, given the small sample size further studies are recommended to arrive at a definitive conclusion. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether acoustic neuroma is associated with noise. Design: PubMed, Cochrane, Embase and CINAHL databases were searched. A meta-analysis was performed to calculate odds ratio (OR) and 95% confidence interval (CI) using quality-effect models. Study sample: A total of eight studies with moderate or high quality involving 75,571 participants met the inclusion criteria. Results: There was no significant relationship between overall noise exposure and acoustic neuroma (OR:1.02, 95% CI: 0.64–1.63). However, further subgroup analysis showed that leisure noise exposure (OR: 1.73, 95% CI: 1.10–2.73), above five years' exposure (OR: 1.81, 95% CI: 1.14–2.85) and continuous exposure (OR:2.77, 95% CI: 1.70–4.49) were associated with an increased risk of acoustic neuroma. Conclusions: These results suggest an elevated risk of acoustic neuroma among individuals who have been exposed to occupational noise when some subgroup analysis are conducted. Leisure noise in particular seems to play a significant role in the development of acoustic neuroma. However, due to the heterogeneity among the included studies, this conclusion should be interpreted with cautions, even though the continuous long-term consequences should not be ignored. [ABSTRACT FROM AUTHOR]

Objective: This systematic review investigated if hearing aid use was associated with acute improvements in cognitive function in hearing-impaired adults. Design: The review question and inclusion/exclusion criteria were designed using the Population, Intervention, Control, Outcomes, and Study design (PICOS) mnemonic. The review was pre-registered in the International Prospective Register of Systematic Review (PROSPERO) and performed in accordance with the statement on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Study sample: Thirteen articles, of various designs, published between 1990 and 2018, were identified via a search of five electronic databases. Results: Most studies reported 1–2 cognitive outcome measures. Nine studies reported a significant improvement in outcome and four studies reported no significant change. None of the 13 studies received a high score on a quality assessment checklist. Due to concerns over risk of bias and indirectness, the overall quality of evidence was graded as low. Conclusions: Only a few studies were identified, some of which report a small improvement in cognitive outcome; however, the overall quality of evidence was low. Further research is very likely to have an important impact on our confidence in answering the review question. [ABSTRACT FROM AUTHOR]

Objective: It is estimated that over 60% of adults with dementia will also have a hearing impairment, resulting in a dual sensory-cognitive communication disability. Hearing interventions may lessen the impact of hearing impairment on a communication disability; yet, for audiologists to recommend appropriate hearing interventions, the individual's hearing thresholds must first be accurately established. The gold standard test for establishing hearing thresholds is pure-tone audiometry (PTA). However, the ability of adults with dementia to successfully complete PTA is uncertain. This systematic review examined studies of adults with dementia to better determine the proportion who could complete PTA. Design: Systematic review. Study sample: Studies were included that assessed hearing in older adults who were reported as having mild and greater dementia. From a total of 1,237 eligible studies, only three were found to meet all inclusion criteria. Results: Across these three studies, the proportion of adults with dementia who could successfully complete PTA ranged from 56% to 59%. Conclusions: Further research is needed in this area, particularly for adults with moderate and severe stages of dementia. Future research should also consider the feasibility of complementary, non-behavioural hearing tests. This systematic review was registered with the PROSPERO database, registration number CRD42017073041. [ABSTRACT FROM AUTHOR]

Objective: Short-term noise exposure that induces transient changes in thresholds has induced permanent cochlear synaptopathy in multiple species. Here, the literature was reviewed to gain translational insight into the relationships between noise exposure, ABR metrics, speech-in-noise performance and TTS in humans. Design: PubMed-based literature search, retrieval and review of full-text articles. Study Sample: Peer-reviewed literature identified using PubMed search. Results: Permanent occupational noise-induced hearing loss (NIHL) is frequently accompanied by abnormal ABR amplitude and latency. In the absence of NIHL, there are mixed results for relationships between noise exposure and ABR metrics. Interpretation of speech-in-noise deficits is difficult as both cochlear synaptopathy and outer hair cell (OHC) loss can drive deficits. Reductions in Wave I amplitude during TTS may reflect temporary OHC pathology rather than cochlear synaptopathy. Use of diverse protocols across studies reduces the ability to compare outcomes across studies. Conclusions: Longitudinal ABR and speech-in-noise data collected using consistent protocols are needed. Although speech-in-noise testing may not reflect cochlear synaptopathy, speech-in-noise testing should be completed as part of a comprehensive test battery to provide the objective measurement of patient difficulty. [ABSTRACT FROM AUTHOR]

Objective: To conduct a systematic review of the evidence in relation to what hearing healthcare professionals do during hearing aid consultations and identifying which behaviours promote hearing aid use and benefit among adult patients. Design: Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, PsycInfo, Web of Science, PubMed and Google Scholar. The Crowe Critical Appraisal Tool and Melnyk Levels of Evidence were used to assess quality and level of evidence of eligible studies. Behaviours of hearing healthcare professionals were summarised descriptively. Study Sample: 17 studies met the inclusion criteria. Results: Twelve studies described behaviours of audiologists and five studies were intervention studies. Audiologists were typically task- or technically-oriented and/or dominated the interaction during hearing aid consultations. Two intervention studies suggested that use of motivational interviewing techniques by audiologists may increase hearing aid use in patients. Conclusions: Most studies of clinicians' behaviours were descriptive, with very little research linking clinician behaviour to patient outcomes. The present review sets the research agenda for better-controlled intervention studies to identify which clinician behaviours better promote patient hearing aid outcomes and develop an evidence base for best clinical practice. [ABSTRACT FROM AUTHOR]

Objective: This review will summarise the current state of development of pharmaceutical interventions (prevention or treatment) for medication-induced ototoxicity. Design: Currently published literature was reviewed using PubMed and ClinicalTrials.gov to summarise the current state of the science. Details on the stage of development in the market pipeline are provided, along with evidence for clinical safety and efficacy reported. Study sample: This review includes reports from 44 articles and clinical trial reports regarding agents in clinical or preclinical trials, having reached approved Investigational New Drug status with the Federal Drug Administration. Results: Vitamins and antioxidants are the most common agents currently evaluated for drug-induced ototoxicity intervention by targeting the oxidative stress pathway that leads to cochlear cell death and hearing loss. However, other strategies, including steroid treatment and reduction of ototoxic properties of the primary drugs, are discussed. Conclusions: Retention of hearing during and after a life threatening illness is a major quality-of-life issue for patients receiving ototoxic drugs and their families. The agents discussed herein, while not mature enough at this point, offer great promise towards that goal. This review will provide a knowledge base for hearing providers to inquiries about such options from patients and interdisciplinary care teams alike. [ABSTRACT FROM AUTHOR]

Objective: To conduct a systematic review of the benefits of non-linear frequency compression (NLFC) in adults and children. Design: Ten databases were searched for studies comparing the effects of NLFC and conventional processing (CP) for the period January 2008 to September 2017. Study sample: Twelve articles were included in this review: four adults and school-aged only, one pre-school only and three with both adults and school-aged children. Results: A two-stage process was implemented to grade the evidence. The individual studies were graded based on their study type (from 1 = highest quality of evidence to 5 = the lowest quality) and then sub-graded based on their quality (“a” for “good quality” or “b” for “lesser quality”). All studies were awarded 4a, except the single pre-school study, which was awarded 2a. The overall evidence for each population was graded based on the quality, quantity and consistency of the studies. The body of evidence was rated as very low for both adults and school-aged children, but high for pre-school children. Conclusion: The low number (and quality) of studies means that evidence supporting the benefit from NLFC is inconclusive. Further high-quality RCTs are required to provide a conclusive answer to this question. [ABSTRACT FROM AUTHOR]

Objective: This systematic review evaluated the effectiveness of two frequency-lowering schemes, non-linear frequency compression and frequency transposition, at improving speech intelligibility for adult hearing-impaired populations. Design: A systematic search of 10 electronic databases was carried out using pre-defined inclusion criteria. Accepted articles were then critically appraised using the Effective Public Health Practice Project (EPHPP) Critical Appraisal Tool. Outcome results were further synthesised where possible using random effects meta-analysis to provide overall combined estimates of the treatment differences along with 95% confidence intervals. Study sample: A total of 20 articles were accepted for final review. Results: Overall, study quality was of moderate strength. Meta-analysis found a statistically significant benefit in favour of frequency-lowering for consonant recognition testing in quiet across 145 participants with both algorithms providing comparable gains. Equivalent results were found between frequency-lowering and conventional processing on all other speech measures. Conclusions: Based on the available data, frequency-lowering does seem to provide some improvement in an individual’s speech intelligibility dependant on the stimulus type, although the benefits were modest. This improvement was not seen across all measures, however those who do not benefit from the technology will also not be harmed by trialling it. [ABSTRACT FROM AUTHOR]

Objectives: To review literature on the use of manual and automatically switching multimemory devices by hearing aid and CI recipients, and to investigate if recipients appreciate and adequately use the ability to switch between programmes in various listening environments. Design: Literature was searched using PubMed, Embase and ISI/Web of Science. Additional studies were identified by screening reference and citation lists, and by contacting experts. Study sample: The search yielded 1109 records that were screened on title and abstract. This resulted in the full-text assessment of 37 articles. Results: Sixteen articles reported on the use of multiple programmes for various listening environments, three articles reported on the use of an automatic switching mode. All studies reported on hearing aid recipients only, no study with CI recipients fulfilled the selection criteria. Conclusions: Despite the high number of manual and automatically switching multimemory devices sold each year, there are remarkably few studies about the use of multiple programmes or automatic switching modes for various listening environments. No studies were found that examined the accuracy of the use of programmes for specific listening environments. An automatic switching device might be a solution if recipients are not able, or willing, to switch manually between programmes. [ABSTRACT FROM AUTHOR]

Objective: The parents/caregivers of a newborn play a pivotal role in the process of hearing screening and intervention. The decisions taken by them depend on their knowledge and attitude. The purpose of this study was to review the literature systematically on knowledge and attitude of parents/caregivers towards infant hearing loss and newborn hearing screening.Design: A systematic search was conducted using electronic databases for the periods from 1990 to March 2016. Two authors scrutinized the studies and extracted the data based on predetermined criteria.Study sample: Ten studies.Results: Ear discharge was correctly identified as a risk factor for hearing loss along with measles, drugs/medication, family history, congenital causes and noise exposure. The studies revealed mixed results for knowledge about newborn hearing screening. Overall, the parents/caregivers showed positive attitudes towards hearing screening and intervention options. However, due to heterogeneity in the studies, it’s hard to derive a conclusion.Conclusions: The present review sheds light on the common areas of misconception among parents/caregivers about risk factors of infant hearing loss and newborn hearing screening. The review also draws attention to the need to have more studies exploring this knowledge and attitude of parents/caregivers among diverse populations. [ABSTRACT FROM PUBLISHER]

Objective: To systematically review and analyse experimental outcomes of studies exploring the impact of tinnitus upon cognitive function and their implications for clinical management of invasive tinnitus.Design: A systematic and descriptive review.Study sample: Eighteen studies were identified investigating the impact of tinnitus on cognitive function.Results: The 18 studies evaluated cognitive function using 24 different objective behavioural tests, nine electrophysiological recordings, one oculomotor test, and one self-report questionnaire. The studies spanned 18 years and revealed numerous interactions potentially contributing to the cognitive difficulties frequently reported by people with invasive tinnitus. The studies indicate a clear association between tinnitus and aspects of cognitive function, specifically the executive control of attention.Conclusions: Tinnitus impairs cognitive function by way of impact upon executive control of attention. Clinical management of patients reporting tinnitus and cognitive difficulties requires an understanding of the reciprocal relationship between tinnitus and cognitive function, with additive effects of anxiety, depression, and somatic cognitive bias. Further study is required to establish the impact of advancing age, hearing loss, anxiety, depression tinnitus duration, and distress upon cognitive function in people with invasive tinnitus. [ABSTRACT FROM PUBLISHER]

Objective: This systematic review aimed to explore the evidence on whether the preferred listening levels (PLLs) and durations of music listening through personal listening devices (PLDs) in adolescents and young adults exceed the current recommended 100% daily noise dose; together with the impact on hearing and possible influential factors of such listening behaviours.Design: A systematic search was conducted using multiple online bibliographic databases.Study sample: The 26 studies were included on the basis of the inclusion and exclusion criteria.Results: The results showed that up to 58.2% of participants exceeded the 100% daily noise dose, particularly in the presence of background noise. Significantly positive correlations were found among background noise levels and mean PLLs, as well as the proportion of participants exceeding the 100% daily noise dose. Moreover, significantly worse hearing thresholds were found in PLD users using audiometry, and significantly poor results in otoacoustic emission (OAE), even in the participants with self-reported ‘normal hearing’.Conclusion: It is crucial to develop appropriate standards and safe recommendations for daily music exposure dose in future studies. Providing an essential guide and effective education to adolescents and young adults will help raise awareness, increase knowledge, and consequently change attitudes and listening habits. [ABSTRACT FROM PUBLISHER]

Objectives: A scoping review focused on background sounds and adult hearing-aid users, including aspects of aversiveness and interference. The aim was to establish the current body of knowledge, identify knowledge gaps, and to suggest possible future directions for research.Design: Data were gathered using a systematic search strategy, consistent with scoping review methodology.Study sample: Searches of public databases between 1988 and 2014 returned 1182 published records. After exclusions for duplicates and out-of- scope works, 75 records remained for further analysis. Content analysis was used to group the records into five separate themes.Results: Content analysis indicated numerous themes relating to background sounds. Five broad emergent themes addressed the development and validation of outcome instruments, satisfaction surveys, assessments of hearing-aid technology and signal processing, acclimatization to the device post-fitting, and non-auditory influences on benefit and satisfaction.Conclusions: A large proportion of hearing-aid users still find particular hearing-aid features and attributes dissatisfying when listening in background sounds. Many conclusions are limited by methodological drawbacks in study design and too many different outcome instruments. Future research needs to address these issues, while controlling for hearing-aid fitting. [ABSTRACT FROM AUTHOR]

Objective:To review and appraise the content and quality of surveys that evaluate hearing aid handling.Design:A systematic and descriptive review.Study sample:Twelve surveys were identified as containing at least one item evaluating hearing aid handling.Results:Fifteen aspects of hearing aid handling were evaluated. None of the surveys evaluated all aspects of handling skills identified. While the majority of studies reported some psychometric evaluation during survey development, the quality of the methodology used and extent of psychometric evaluation reported varied considerably.Conclusions:There is currently no single survey that evaluates handling skills comprehensively. In the absence of an ideal survey, the Practical Hearing aid Skills Test appears to be the most inclusive clinician-administered survey and the Hearing aid User's Questionnaire appears to be the most inclusive self-report survey evaluating hearing aid handling precision; however, there are limitations in the analysis of their psychometric properties. Nonetheless, use of these surveys in clinical practice could identify areas of handling that warrant additional training in order to improve hearing aid success. Research identifying the full range of hearing aid handling skills necessary for successful hearing aid use will further contribute knowledge to the complex construct of successful hearing aid-use. [ABSTRACT FROM PUBLISHER]

Objective: A systematic literature review and meta-analysis was performed to determine the effect of stimulus type, SCM muscle activation method, transducer type, and method to control SCM muscle EMG level on response parameter values for 0.1-ms click-evoked and 500-Hz tone burst cVEMPs. A description of normative response values was attempted. Design: An electronic systematic literature review was performed to obtain normative cVEMP response data. Subsequently a meta-analysis was conducted to determine significant effects on cVEMP response parameters and to obtain norms. Study sample: Scopus was used to identify reports containing normative data. Reports were selected based on inclusion and exclusion criteria determined beforehand. Weighted means were calculated and compared to identify significant effects and normative data. Results: Sixty-six reports were included in the systematic review. Stimulus type, SCM muscle activation method, transducer type, and method to control SCM muscle EMG level had significant effects on all response parameters. Conclusions: Optimal stimulus and recording parameters suggested by previous research are confirmed by the current systematic review and meta-analysis and are suggested for clinical use. Response parameter values are influenced by variations in stimulus and recording parameters and normative response values are suggested as guideline for cVEMP interpretation. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions. Design: We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and interrupted time-series of hearing loss prevention among workers exposed to noise. Study sample: We included 19 studies with 82 794 participants evaluating effects of hearing loss prevention programs (HLPP). The overall quality of studies was low to very low, as rated using the GRADE approach. Results: One study of stricter legislation showed a favorable effect on noise levels. Three studies, of which two RCTs, did not find an effect of a HLPP. Four studies showed that better use of hearing protection devices in HLPPs decreased the risk of hearing loss. In four other studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz (95% CI − 0.5 to 1.7) than non-exposed workers. In two similar studies there was a substantial risk of hearing loss in spite of a HLPP. Conclusions: Stricter enforcement of legislation and better implementation of HLPPs can reduce noise levels in workplaces. Better evaluations of technical interventions and long-term effects are needed. [ABSTRACT FROM AUTHOR]

Abstract Objective: This investigation quantified the relative benefits of binaural CI arrangements (i.e., bilateral, bimodal) for three binaural phenomena (i.e., binaural squelch, binaural summation, head-shadow effect) and sensitivity of two speech-recognition test paradigms (i.e., adaptive and fixed). Design: A repeated-measures meta-analytical approach was used to compare effect sizes between binaural CI arrangements for each of the three binaural-listening phenomena and between the two test paradigms. Study sample: A total of 95 effect sizes were calculated and analyzed from 42 peer-reviewed studies published between January 2000 and April 2011. Results: Findings revealed significant effect sizes for both CI arrangements for the binaural phenomena of summation and head-shadow effect. A significant effect size for binaural squelch was determined only for bilateral CI users. Further, the two paradigms resulted in similar effect sizes for bilateral and bimodal users, with the exception of binaural squelch. Here, significant effect sizes were significant only in the fixed-testing paradigm. Conclusions: The average user of binaural CI arrangements realizes the binaural phenomena of summation and the head-shadow effect, but only the bilateral CI arrangement is afforded the advantage of binaural squelch. Statistically, listeners fit with bilateral CIs have a slight advantage in binaural performance over those using bimodal stimulation. Sumario Objetivo: Esta investigación cuantifica los beneficios relativos de las adaptaciones binaurales de IC (p.e., bilaterales, bimodales) en cuanto a tres fenómenos binaurales (p.e., chapoteo binaural, sumación binaural, efecto de sombra de la cabeza) y la sensibilidad de dos paradigmas de prueba para el reconocimiento del lenguaje. Diseño: Se utilizó un enfoque meta-analítico de medidas repetidas para comparar el grado del efecto en las adaptaciones binaurales de CI para cada uno de los tres fenómenos de audición binaural y entre los dos paradigmas de prueba. Muestra Del Estudio: Se calculó y se analizó un total de 95 efectos en 42 estudios con revisión editorial, publicados entre enero del 2000 y abril del 2011. Resultados: Los hallazgos revelaron grados significativos de efecto para ambas adaptaciones de CI, tanto para el fenómeno de sumación como para el de efectos sombra de la cabeza. Se determinó un grado significativo de efecto para el chapoteo binaural sólo para los usuarios de CI bilaterales. Más aún, los dos paradigmas rindieron resultados de grado similar para usuarios bilaterales y bimodales, con la excepción del chapoteo binaural. Aquí, los grados de efecto fueron significativos solamente para el paradigma de prueba fija. Conclusiones: El usuario promedio con adaptación binaurales de CI se da cuenta del fenómeno binaural de sumación y el efecto de sombra de la cabeza, pero solo al arreglo de CI bilateral le da la ventaja del chapoteo binaural. Estadísticamente, los sujetos adaptados con CI bilaterales tienen una ligera ventaja en el desempeño binaural sobre aquellos que utilizan estimulación bimodal. [ABSTRACT FROM AUTHOR]

Abstract Objective: Xylitol can be a prophylaxis for acute otitis media (AOM), especially when administered via chewing gum, but that vehicle has limitations for children. This review sought evidence for links of mother-child transmission of bacteria and as a vehicle for xylitol as a prophylaxis for dental caries and its translation to AOM in infants and young children. Design: Qualitative systematic review. Method: Combining output from 43 search strings used earlier and submitting 20 new strings to PubMed resulted in 14 studies (six were excluded; eight were included). Included studies had to be published in English-language, peer-reviewed journals; involve mothers using xylitol; and assess bacteria or caries in their children. Evaluation forms were completed for search, retrieval, and quality assessment of included studies. Results: The studies showed that mothers' chewing xylitol gum was a prophylaxis against bacteria and caries in their children. A mother-child transmission model was presented as a possible vehicle for use in comprehensive prevention programs for AOM. Conclusions: Potential for xylitol use to prevent AOM warrants further study. A mother-child model may apply to AOM for transmission of bacteria and as a prophylaxis, but alternative vehicles like nasal sprays should be investigated for ease of use and effectiveness. Sumario Objetivo: El Xylitol puede ser un profiláctico para la otitis media aguda (AOM), especialmente cuando se administra en forma de goma de mascar, pero ese vehiculo tiene sus limitaciones en los niños. Esta revisión buscó evidencias sobre la conexión de la transmisión de la bacteria entre madre e hijo y el Xylitol como vehículo de profilaxis para la caries dental y su conversión a AOM en bebés y niños. Diseño: Revisión sistemática cuantitativa. Metodo: Se combinaron los resultados de 43 líneas de búsqueda utilizadas anteriormente con 20 nuevas líneas de búsqueda a PubMed; se obtuvieron 14 estudios (se excluyeron seis y se incluyeron ocho). Los estudios incluidos tenían que estar publicados en revistas en inglés, con revisión editorial; que incluyeran a madres utilizando Xylitol; y una evaluación de bacterias o caries en sus niños. Resultados: Los estudios demostraron que las madres que masticaban Xylitol eran un profiláctico contra bacterias y caries en sus niños. Se presenta un modelo de transmisión madre-hijo como posible vehículo para ser utilizado en los programas de prevención integral de la AOM. Conclusiones: El potencial del Xylitol en la prevención de la AOM requiere mayor estudio. Es posible que se pueda aplicar un modelo de transmisión de bacterias entre madre e hijo en la AOM y como profiláctico; pero un vehículo alternativo como el spray nasal debe ser investigado para facilitar su uso y efectividad. [ABSTRACT FROM AUTHOR]

Abstract A systematic review was conducted to evaluate evidence regarding xylitol, a sugar alcohol, as a prophylaxis for acute otitis media (AOM) in children. The authors searched PubMed and other databases to identify evidence. Criteria for included studies were: appear in English-language, peer-reviewed journals; at least quasi-experimental designs; use xylitol; and present outcome data. The authors completed evaluation forms for the included studies at all phases of the review. The authors reviewed 1479 titles and excluded 1435. Abstracts and full texts were reviewed for the remaining 44; four randomized controlled trials met inclusion criteria. Xylitol was a generally well accepted prophylaxis for AOM with few side effects when administered via chewing gum or syrup at 10 g/day given five times daily. Meta-analysis revealed significant treatment effects (Risk ratio = 0.68; 95% confidence interval = 0.57 to 0.83). Xylitol can be a prophylaxis for AOM, but warrants further study, especially of vehicles other than chewing gum for young children, and information is needed regarding cost, duration of administration required, and expected long-term effects. Sumario Se llevó a cabo una revisión sistemática para evaluar la(s) evidencia(s) sobre el Xylitol, un alcohol de azúcar, como profiláctico para la otitis media aguda en niños (AOM). Los autores buscaron en PubMed y en otras bases de datos para identificar las evidencias. Los criterios para incluir los estudios fueron: que apareciera en idioma inglés, en revistas revisadas por científicos de la misma disciplina con un diseño al menos quasi experimental; con uso de Xylitol y con resultados. Los autores completaron las formas de evaluación para los estudios incluidos en todas las fases de la revisión. Los autores revisaron 1479 títulos y excluyeron 1435. Se revisaron sumarios y artículos completos de los 44 restantes; cuatro ensayos clínicos aleatorios controlados cumplieron los criterios de inclusión. En general el Xylitol fue bien tolerado en la profilaxis de la AOM con pocos efectos colaterales cuando se administró en goma de mascar o sirope a dosis de 10g/día en cinco tomas. El meta-análisis reveló efectos terapéuticos significativos (tasa de riesgo de 0.68; intervalo de confianza del 95% 0.57 a 0.83) El Xiylitol puede ser una profilaxia para la AOM, pero se requieren más estudios, especialmente acerca de otros vehículos distintos a la goma de mascar para niños pequeños, y es necesaria mayor información sobre los costos, la duración requerida y los efectos esperados a largo plazo. [ABSTRACT FROM AUTHOR]