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In research on the psychological development of deaf and hard-of-hearing (DHH) children, there is a wealth of studies focused on aspects such as speech and language, communication, and social-emotional development, but some other spheres have been disregarded. This study looks more generally at the developmental outcomes of DHH children who use cochlear implants (CIs). The participants were one group of DHH children 3 and 4 years old who used a CI and another age-matched control group with normal hearing and typical development (the TD group). The "Psychomotor Development Evaluation Cards" were used to evaluate the groups. Additionally, information about deafness, the CI, and health of the child and mother was obtained from medical records. For 3-year-olds, DHH children had lower scores than TD children in motor development, communication and speech, behavioural development, and knowledge and learning. However, 4-year-old DHH children had lower scores than TD children only in the social-emotional domain. In the 4-year-olds, positive correlations were also found between speech and communication development and knowledge and learning. Our results show that it is essential to offer early holistic support to DHH children who use a CI in terms of their global development, including social-emotional development.

Introduction: The purpose of this study was to evaluate three chatbots – OpenAI ChatGPT, Microsoft Bing Chat (currently Copilot), and Google Bard (currently Gemini) – in terms of their responses to a defined set of audiological questions. Methods: Each chatbot was presented with the same 10 questions. The authors rated the responses on a Likert scale ranging from 1 to 5. Additional features, such as the number of inaccuracies or errors and the provision of references, were also examined. Results: Most responses given by all three chatbots were rated as satisfactory or better. However, all chatbots generated at least a few errors or inaccuracies. ChatGPT achieved the highest overall score, while Bard was the worst. Bard was also the only chatbot unable to provide a response to one of the questions. ChatGPT was the only chatbot that did not provide information about its sources. Conclusions: Chatbots are an intriguing tool that can be used to access basic information in a specialized area like audiology. Nevertheless, one needs to be careful, as correct information is not infrequently mixed in with errors that are hard to pick up unless the user is well versed in the field. [ABSTRACT FROM AUTHOR]

Testing of ChatGPT has recently been performed over a diverse range of topics. However, most of these assessments have been based on broad domains of knowledge. Here, we test ChatGPT's knowledge of tinnitus, an important but specialized aspect of audiology and otolaryngology. Testing involved evaluating ChatGPT's answers to a defined set of 10 questions on tinnitus. Furthermore, given the technology is advancing quickly, we re-evaluated the responses to the same 10 questions 3 and 6 months later. The accuracy of the responses was rated by 6 experts (the authors) using a Likert scale ranging from 1 to 5. Most of ChatGPT's responses were rated as satisfactory or better. However, we did detect a few instances where the responses were not accurate and might be considered somewhat misleading. Over the first 3 months, the ratings generally improved, but there was no more significant improvement at 6 months. In our judgment, ChatGPT provided unexpectedly good responses, given that the questions were quite specific. Although no potentially harmful errors were identified, some mistakes could be seen as somewhat misleading. ChatGPT shows great potential if further developed by experts in specific areas, but for now, it is not yet ready for serious application. [ABSTRACT FROM AUTHOR]

The purpose of this pilot study was to evaluate the magnitude of the medial olivocochlear reflex (MOCR) estimated by the reduction in tone-burst evoked otoacoustic emissions (TBOAEs) measured at three levels and at three frequencies in response to fixed contralateral white noise. Results were compared with commonly used click-evoked otoacoustic emissions (CEOAEs). TBOAEs and CEOAEs, with and without contralateral 60 dB SPL white noise, were measured in response to stimulation at 55, 65, and 75 dB peSPL. In each subject, the set of measurements was performed twice. Of particular interest were the MOCR and its repeatability. 15 normally hearing persons (13 women, average age 32.3 years, SD = 8.1). For both CEOAE and TBOAEs, the reliability of the MOCR was much better for broadband measurements than for half-octave-band filtered estimates. At the same time, the reliability of MOCR in half-octave bands was higher for TBOAEs than for CEOAEs, especially at 2 and 4 kHz. For general applications where broadband MOCR is of interest, the highest magnitude and reliability is provided by CEOAEs. However, TBOAEs may be better if a particular frequency band is of interest. [ABSTRACT FROM AUTHOR]

The aim of this interventional non-randomised prospective controlled study was to assess the effectiveness of transcutaneous vagus nerve stimulation (tVNS) in human subjects with tinnitus. The ParasymTM tVNS device was paired with an auditory stimulation. Treatment and observations were conducted over 12 weeks. Audiological evaluation was performed. Responses from a set of questionnaires and quantitative electroencephalography (qEEG) before and after treatment were collected. Voice measurements were done to assess possible side-effects of tVNS. The study involved 29 adults who had chronic tinnitus (15 patients who underwent tVNS paired with sounds and a control group of 14 patients who did not). In general, subjective and objective measurements of tinnitus showed no improvement in the study group compared to the controls, although certain parameters as gauged by the questionnaires did statistically improve. The loudness and frequency of tinnitus remained the same in both groups. For the qEEG, activity in the theta band increased significantly in the study group compared to the control group. The tVNS was not effective in reducing tinnitus symptoms in our study group. However, changes in the theta band suggest there might be cortical effects that might, with sustained treatment, lead to improvements. [ABSTRACT FROM AUTHOR]

This study looked at the possible effect of the COVID-19 pandemic on individuals who came to our clinic seeking relief from tinnitus. The performance of the subjects during the COVID-19 pandemic was compared with similar individuals who came to our clinic before the pandemic began. The study involved 50 adults with chronic tinnitus, made up of a study group (24 subjects tested during the COVID-19 pandemic of 2020–2021) and a control group before the pandemic began (26 subjects tested from 2013 to 2017). None of the 24 reported having contracted COVID-19. Data collection involved the Tinnitus Handicap Inventory (THI) questionnaire, audiological tests, and quantitative electroencephalography (qEEG). In terms of THI scores, there were no statistically significant differences between the two groups. However, with regard to qEEG, some changes were observed, with significant decreases in alpha and beta band activity in the study group compared to the control group, particularly over the auditory cortex. We conclude that COVID-19 did not have a discernible impact on the general well-being of individuals with tinnitus. However, it did appear to alter brain activity, specifically in the alpha and beta bands over the auditory cortex, and these reults warrant further investigation. [ABSTRACT FROM AUTHOR]

In research on the psychological development of deaf and hard-ofhearing (DHH) children, there is a wealth of studies focused on aspects such as speech and language, communication, and socialemotional development, but some other spheres have been disregarded. This study looks more generally at the developmental outcomes of DHH children who use cochlear implants (CIs). The participants were one group of DHH children 3 and 4 years old who used a CI and another age-matched control group with normal hearing and typical development (the TD group). The Psychomotor Development Evaluation Cards were used to evaluate the groups. Additionally, information about deafness, the CI, and health of the child and mother was obtained from medical records. For 3-year-olds, DHH children had lower scores than TD children in motor development, communication and speech, behavioural development, and knowledge and learning. However, 4-year-old DHH children had lower scores than TD children only in the socialemotional domain. In the 4-year-olds, positive correlations were also found between speech and communication development and knowledge and learning. Our results show that it is essential to offer early holistic support to DHH children who use a CI in terms of their global development, including social-emotional development. [ABSTRACT FROM AUTHOR]

Hearing is normally evaluated up to 8 kHz, even though testing can easily be performed at higher frequencies (up to 16 or 20 kHz). The range beyond 8 kHz is often referred to as the extended high frequency (EHF) range. This study aimed to explore the relationship between EHF hearing thresholds (HTs) and distortion product otoacoustic emissions (DPOAEs) in adult subjects. Also of interest were the effects of the presence of spontaneous otoacoustic emissions (SOAEs), gender, ear side, and age. The main finding was that DPOAEs, both within the standard frequency (SF) range (0.125–8 kHz) and the EHF range (10–16 kHz), decrease as thresholds deteriorate. For both ranges, DPOAEs and HTs depend on age, even for those with normal hearing, although EHFs seem to be especially affected by age. The presence of SOAEs was the only other factor that significantly influenced DPOAE level. For both DPOAEs and HTs, only minor and non-significant effects were related to gender and ear side. It was concluded that DPOAEs in the EHF range appear to be good predictors of EHF HTs. Moreover, since DPOAEs and HTs in the EHF range both correlate with age, these two measures may be suitable markers for incipient presbycusis. [ABSTRACT FROM AUTHOR]

Background and Objectives: This narrative review of the literature explores the effect of body temperature on hearing. In particular, its focus is on extended high frequency (EHF) hearing—the range beyond the standard audiometric limit of 8 kHz. Such high frequencies are the first to be affected by noise-induced hearing loss, and so monitoring them can provide an early warning sign of incipient damage. Materials and Methods: This review builds on a personal literature database of 216 references covering the general topic of EHF hearing; the procedure was to then identify papers related to whole-body or cochlear cooling. A starting point was the paper by Munjal et al. who in 2013 reported changes of up to 15–30 dB in the EHF thresholds of subjects who had undergone cardiopulmonary bypass (CBP) surgery, which typically involves mild to moderate hypothermia—cooling of the blood—to reduce cellular oxygen demand and minimise tissue damage. Results: Reviewing the surrounding literature, we find that although CBP surgery by itself can impair hearing thresholds, lower body and cochlear temperatures in general provide neuroprotective effects. A connection between hearing loss and CBP surgery has been periodically documented, but the mechanism behind it has yet to be conclusively identified. Conclusions: The observations reviewed here tend to confirm the otoprotective effects of cooling. We consider that the high sensitivity of EHF thresholds to temperature is a major factor that has not been sufficiently recognised, although it has important implications for otological research and practice. Two important inferences are that, first, monitoring EHF thresholds might have considerable value in audiology, and, second, that lowering temperature of the cochlea during cochlear implantation might provide substantially better hearing preservation, as some researchers have already suggested. [ABSTRACT FROM AUTHOR]

The purpose of the study was to measure the variability of transiently evoked otoacoustic emissions (TEOAEs) and the medial olivocochlear reflex (MOCR) over a long period of time in one person. TEOAEs with and without contralateral acoustic stimulation (CAS) by white noise were measured, from which MOCR strength could be derived as either a dB or % change. In this longitudinal case study, measurements were performed on the right and left ears of a young, normally hearing adult female once a week for 1 year. The results showed that TEOAE level and MOCR strength fluctuated over the year but tended to remain close to a baseline level, with standard deviations of around 0.5 dB and 0.05 dB, respectively. The TEOAE latencies at frequencies from 1 to 4 kHz were relatively stable, with maximum changes ranging from 0.5 ms for the 1 kHz band to 0.08 ms for the 4 kHz band. TEOAE levels and MOCR strengths were strongly and negatively correlated, meaning that the higher the TEOAE level, the lower the MOCR. Additionally, comparison of fluctuations between the ears revealed positive correlation, i.e., the higher the TEOAE level or MOCR in one ear, the higher in the second ear. [ABSTRACT FROM AUTHOR]

This study investigated whether visual attention affects the reliability (i.e., repeatability) of transiently evoked otoacoustic emission (TEOAE) magnitudes or of medial olivocochlear reflex (MOCR) estimates. TEOAEs were measured during three visual attentional conditions: control (subject were seated with eyes closed); passive (subjects looked at a pattern of squares on a computer screen); and active (subjects silently counted an occasionally inverted pattern). To estimate reliability, the whole recording session was repeated the next day. The results showed that visual attention does not significantly affect TEOAE or MOCR magnitudes—or their reliability. It is therefore possible to employ visual stimuli (e.g., watching a silent movie) during TEOAE experiments, a procedure sometimes used during testing to prevent subjects from falling asleep or to keep children still and quiet. [ABSTRACT FROM AUTHOR]

The medial olivocochlear reflex (MOCR), usually assessed by the inhibition of transiently evoked otoacoustic emissions (TEOAEs) with contralateral noise, is a very small effect. In understanding the origin of the MOCR, it is crucial to obtain data of the highest accuracy, i.e., with a high signal-to-noise ratio (SNR), which in turn largely depends on the number of signal averages. This study investigates how the reliability of MOCR measures is affected by the number of averages. At the same time, the effect of the presence of synchronized spontaneous otoacoustic emissions (SSOAEs) is taken into account, as it is known that this factor significantly affects TEOAE amplitudes and SNRs. Each recording session consisted of two series of four measurements, allowing comparison of MOCR magnitude based on 250, 500, 750, and 1000 averages. Reliability was based on comparing the two series. The results show that, for a good quality MOCR measure (i.e., intraclass correlation above 0.9), the required number of averages is at least double that obtainable from a standard TEOAE test (i.e., 500 compared to 250). Ears without SSOAEs needed a higher number of averages to reach a correlation of 0.9 than ears with SSOAEs. [ABSTRACT FROM AUTHOR]

Self-help (without specialist support) can play an important role in tinnitus therapy. The purpose of this study was to investigate what fraction of subjects with tinnitus use self-help, what techniques are most commonly used to reduce tinnitus severity, and what distinguishes patients that use self-help from others. retrospective, observational study Adult patients admitted to our hospital clinic (460 participants) aged 19–83 years and reporting chronic tinnitus. The survey concerned therapy attempts prior to the clinic visit as well as self-help techniques chosen freely by the patient to reduce tinnitus severity. Data showed that 40.9% of the respondents chose some action themselves to reduce their tinnitus severity. Among the reported self-help techniques, acoustic stimulation was the most popular. In addition, patients chose distraction attention, relaxation, meditation, yoga, and physical activity. The likelihood of undertaking self-help increases with better education and higher tinnitus severity. Knowledge about patients' preferences of forms of self-help may help the health practitioner suggest a more suitable form of therapy. Due to the great interest in using sound therapy in tinnitus, it would be worthwhile looking at new forms of this therapy, for example increasingly popular mobile applications. [ABSTRACT FROM AUTHOR]

• Cortical activity may reach inner ear through medial olivocochlear (MOC) neurons. • We investigated whether attending to auditory tasks modulated inner ear function. • The effect of attention is not directly visible in the MOC reflex. • The MOC reflex grows with the amount of cortical resources used in task processing. • This suggests a mutual compensation mechanism between periphery and cortex. The medial olivocochlear (MOC) system is thought to be responsible for modulation of peripheral hearing through descending (efferent) pathways. This study investigates the connection between peripheral hearing function and auditory attention tasks of different degrees of difficulty. Peripheral hearing function was evaluated by analyzing the amount of change in otoacoustic emissions (OAEs) by contralateral acoustic stimulation (CAS), a well-known effect of the MOC system. Simultaneously, levels of attention were evaluated by event-related potentials (ERPs). The ERPs showed clear differences in processing tasks of different difficulty, but paradoxically there was no difference in the amount of OAE change brought about by CAS. There was also no effect on OAE latency, nor was there any difference in noise level or number of rejected trials. However, we observed that the changes in OAEs by CAS for easy and hard tasks were correlated with the magnitude of the P3 wave in the ERP. This suggests there might be some sort of mutual compensation mechanism – presently unknown – between periphery and cortex. [ABSTRACT FROM AUTHOR]

To investigate the relationship between self-perceived global stress and the personality traits of mothers of children with central auditory processing disorders (APD), and make a comparison with mothers of typically developing (TD) children. A cross-sectional study using two questionnaires – the Perceived Stress Scale (PSS-10) and the Short Big Five Markers (IPIP-BFM-20) – to assess five personality dimensions: extraversion, agreeableness, conscientiousness, emotional stability, and intellect/imagination. The study material included 187 mothers, of whom 108 were mothers of children with APD. The average age of the children with APD was 10 years. The average level of global stress was similar in mothers of children with APD and mothers of TD children. Mothers of APD children had significantly lower scores for personality dimensions such as: emotional stability, conscientiousness, and intellect/imagination. Increased perceived stress level in mothers of children with APD was inversely correlated with extraversion, conscientiousness, and emotional stability. However, for both groups of mothers, the only significant predictor of global stress level was emotional stability. Mothers of children with APD, despite having similar global stress levels to other mothers, were different in terms of three personality dimensions, and these, especially lowered emotional stability, may play a negative role in coping with global self-perceived stress. The results of this study might be helpful in parental support interventions, including psychological therapy and counselling, and also in parental implementation interventions aimed at mothers of children with APD, especially those mothers who have high global stress and/or low emotional stability. • Global self-perceived stress in mothers of APD children and those with TD is similar. • Mothers differ in personality dimensions such as emotional stability, conscientiousness, and intellect/imagination. • Extraversion, conscientiousness, and emotional stability are conducive to reducing stress in mothers of APD children. • Only emotional stability explains the level of global self-perceived stress in mothers of both groups of children. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the reliability of the medial olivocochlear reflex (MOCR) between men and women. The strength of the MOCR was measured in terms of the suppression of transiently evoked otoacoustic emissions (TEOAEs) by contralateral acoustic stimulation (CAS). The difference between TEOAEs with and without CAS (white noise) was calculated as raw decibel TEOAE suppression as well as normalized TEOAE suppression expressed in percent. In each subject, sets of measurements were performed twice. Reliability was evaluated by calculating the intraclass correlation coefficient, the standard error of measurement, and the minimum detectable change (MDC). The study included 40 normally hearing subjects (20 men; 20 women). The estimates of MOCR for both genders were similar. Nevertheless, the reliability of the MOCR was poorer in men, with an MDC around twice that of women. This can be only partially attributed to slightly lower signal-to-noise ratios (SNRs) in men, since we used strict procedures calling for high SNRs (around 20 dB on average). Furthermore, even when we compared subgroups with similar SNRs, there was still lower MOCR reliability in men. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess whether cochlear implant (CI) users who had been postlingually deaf developed a more positive outlook on life—the so-called posttraumatic growth (PTG)—as a result of their disability and to examine how PTG related to their stress-coping strategies and personal circumstances. The study group consisted of 119 postlingually deaf CI users. The participants were asked to anonymously fill in several questionnaires: the Post-Traumatic Growth Inventory (PTGI), Coping Orientations to Problems Experienced (Brief COPE), and a form asking for personal details and factors related to their deafness and CI use. The PTG of postlingually deaf CI users was similar to that found in people with other severe health problems. The time that had elapsed since the hearing was lost and the time from receiving a CI were positively correlated with PTG. The level of PTG was correlated with the particular coping strategies used and differed between men and women. We found that the development of PTG could emerge from both approach-oriented coping strategies (e.g., active coping and planning) and avoidance-oriented coping strategies (e.g., denial, self-distraction, and self-blame). Paradoxically, the avoidance strategies could play a positive role in the development of PTG. This reinforces the idea, previously raised in the PTG literature, that such strategies exert a defensive and protective function—an "illusory" side of PTG—which operates together with the positive constructive side, and both help develop the sense of well-being of a person. [ABSTRACT FROM AUTHOR]

The purpose of the study was to determine the reliability in children of the medial olivocochlear reflex when measured as decibels of suppression of transiently evoked otoacoustic emissions (TEOAEs) by contralateral acoustic stimulation (CAS). TEOAEs with and without CAS (white noise) were measured. In each subject, measurements were performed twice. Of particular interest was the suppression of TEOAEs by CAS and its reliability. Reliability was evaluated by calculating the standard error of measurement (SEM) and minimum detectable change (MDC). Fifty-one normally hearing girls aged 3–6 years. The average global TEOAE suppression was around 0.6 dB. The highest reliability was for global values, with SEM of 0.2 dB and MDC of ±0.55 dB for the standard 2.5–20 ms recording window and slightly higher values for an 8–18 ms window. The worst reliability in the studied group was for the 1 kHz half-octave frequency band. Additionally, ears without spontaneous otoacoustic emissions had higher suppression levels than those with, but they also had lower signal-to-noise ratios, which may limit their clinical utility. The current study shows that, under the studied paradigm, TEOAE suppression does not have satisfactory reliability since MDC was similar to the level of suppression. [ABSTRACT FROM AUTHOR]

The sensitivity of the auditory system is regulated via two major efferent pathways: the medial olivocochlear system that connects to the outer hair cells, and by the middle ear muscles—the tensor tympani and stapedius. The role of the former system in suppressing otoacoustic emissions has been extensively studied, but that of the complementary network has not. In studies of selective attention, decreases in otoacoustic emissions from contralateral stimulation have been ascribed to the medial olivocochlear system, but the acknowledged problem is that the results can be confounded by parallel muscle activity. Here, the potential role of the muscle system is examined through a wide but not exhaustive review of the selective attention literature, and the unifying hypothesis is made that the prominent "physiological noise" detected in such experiments, which is reduced during attention, is the sound produced by the muscles in proximity to the ear—including the middle ear muscles. All muscles produce low‐frequency sound during contraction, but the implications for selective attention experiments—in which muscles near the ear are likely to be active—have not been adequately considered. This review and synthesis suggests that selective attention may reduce physiological noise in the ear canal by reducing the activity of muscles close to the ear. Indeed, such an experiment has already been done, but the significance of its findings have not been widely appreciated. Further sets of experiments are needed in this area. [ABSTRACT FROM AUTHOR]

Otoacoustic emissions (OAEs) are currently used as a valuable audiological test or as a hearing screening tool. There are many commercially available OAE recording systems that are used both for clinical practice and for research. However, there is little information in the literature comparing their performance in detecting hearing loss. The purpose of this prospective, nonrandomized, and controlled study was to evaluate the screening performance obtained from recent and older versions of the Otometrics Accuscreen OAE screening device in comparison with the Otodynamics ILO-292 OAE system, which has been used as the gold standard. Testing included otoscopic assessment, pure tone audiometry, tympanometry, and transiently evoked OAE (TEOAE) recordings. There was about a 77% agreement between the two versions of the Accuscreen device. Agreement between the two Accuscreen devices and the ILO was approximately 70% for the old and 80% for the new. The newer version of Accuscreen seems to perform better than the old, being more consistent with the reference ILO system and with the audiometry profiles of the tested subjects. In order to set robust standards for OAE evaluation and analysis, additional studies comparing different OAE hearing screening systems are needed. [ABSTRACT FROM AUTHOR]

A child's disability is a risk factor for its parents experiencing parental burnout (PB). Here we investigate this problem in hearing mothers of deaf and hard of hearing (DHH) children. We look at the psychological dimension of the mothers' personality in terms of the Big Five model, satisfaction with life (SWL), and posttraumatic growth (PTG). Eie study takes account of the sociodemographics of the mothers and their children and other factors related to the child's deafness and their type of hearing assistance. Eie study was conducted through letters sent to 559 hearing mothers of which 29% responded. Responding mothers completed several questionnaires: the Parental Burnout Measure (PBM-12), International Personality Item Pool-Big Five Markers-20 (IPIP-BFM-20), Posttraumatic Growth Inventory (PTGI), and a general questionnaire. A VAS scale was used to assess SWL and satisfaction with the child's rehabilitation. Results showed that the level of PB the mothers experienced was significantly lower than in mothers of children with non-deafness disabilities. SWL and emotional stability, intellect/imagination, agreeableness, extraversion, and satisfaction with the child's rehabilitation were inversely correlated with PB, but only SWL and emotional stability were significant PB predictors. PTG in the mothers was at an average level and not correlated with PB. Similarly, the sociodemographic characteristics of mother and child and child's deafness -related factors were not correlated with PB. Low levels of emotional stability and SWL are associated with vulnerability of the mothers to PB. Our finding of a lack of relationship between PB and PTG suggest that some mothers of deaf children may experience "illusory PTG", which is related to avoidance -oriented coping strategies including denial coping. [ABSTRACT FROM AUTHOR]

Background: Every year more people suffer from tinnitus. Therapy for the condition requires a comprehensive approach to the patient. Despite the existence of many treatment methods, none is 100% effective. After a physician has excluded organic diseases, it is standard practice to try sound therapy. The aim of this study was to evaluate the effectiveness of sound therapy by means of a free mobile application ReSound Tinnitus Relief in a patient with very troublesome tinnitus. Case study: The patient, a 34-year-old woman, reported very troublesome tinnitus, described as a constant, non-pulsating ringing sound felt "inside the head". The patient was offered sound therapy using a widely available application installed on a mobile phone. Progress of the therapy and changes in tinnitus perception were evaluated using two standardized questionnaires: the Tinnitus Handicap Inventory and the Tinnitus Functional Index. Results from both questionnaires showed that overall tinnitus annoyance decreased after 3 and 6 months of use. Conclusions: The data demonstrate that the use of sound therapy on a mobile app can provide satisfactory results, at least in this patient. However, it is not possible to say that such sound therapy will bring relief to all patients. Nevertheless, it is an option that a doctor can offer to their patient. A further study is needed on a large group of people to confirm whether it is possible to replace conventional sound generators with mobile solutions. [ABSTRACT FROM AUTHOR]

Background: Distortion product otoacoustic emissions (DPOAEs) are usually measured in a frequency range up to 8 kHz, although some systems permit measurements up to 16 kHz. For any test to be reliable it is important to determine its repeatability. Therefore in the present study DPOAE recordings were made using the SmartOAE system with a focus on the repeatability of high-frequency DPOAEs. Material and methods: DPOAEs were measured in subjects with normal hearing from 0.25 to 16 kHz. Recordings were made at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12.5, 14, and 16 kHz. Each recording session consisted of three measurements: the first two performed without removing the probe from the ear (single fit mode), and the third after removing and re-inserting it into the ear canal (multiple fit mode). Recordings from 15 ears were made. Results: In single fit mode, the biggest fluctuations were obtained at 0.75, 8, 11, 12.5, and 14 kHz -- the largest was 2.8 dB. In the multiple fit mode, greater variability was obtained compared to measurements made without removing the probe -- the largest reached 3.4 dB. Conclusions: Even though the measured signals significantly exceeded the noise floor, differences between measurements for some frequencies still reached as high as 3.4 dB. Our work confirms the usefulness of testing very high DPOAE frequencies (>8 kHz), but at the same time some caution is needed when interpreting the results. [ABSTRACT FROM AUTHOR]

Objective: Self-esteem is a good predictor of mental health and is crucial for well-being and psychological functioning. It is especially important in situations where there are potential mental health problems, such as in people suffering from hearing loss or total deafness. This study aims to gauge the level of self-esteem in adults with hearing problems, in particular those who, in adulthood, had received a cochlear implant (CI). The subjects had different onset (pre-lingual/post-lingual) and amount (deafness/partial deafness) of hearing loss, and their current level of self-esteem was compared to that of the general population. The association of self-esteem with other deafness-related variables (e.g. satisfaction with their CI or whether they also used a hearing aid) and sociodemographic factors was also investigated. Methods: Data were obtained from questionnaires mailed to patients who, when adult, had received a CI. The subjects were divided into four subgroups: subjects with pre-lingual deafness, post-lingual deafness, pre-lingual partial deafness, and post-lingual partial deafness. To evaluate their self-esteem, the Rosenberg Self-Esteem Scale (RSES) was used. For data on sociodemographic status and information related to deafness and CI, we used our own Information Inquiry form. For statistical analysis of the results, we compared means (t-test, ANOVA), investigated correlations, and applied linear regression. Results: The self-esteem of deaf and partially deaf CI users was significantly lower than in the general population, especially for post-lingually deafened subjects. The only factor related to deafness and CIs that explained self-esteem was self-rated satisfaction with the CI–meaning that higher satisfaction was associated with higher self-esteem. The major sociodemographic factor that explained self-esteem was marital/partnership status (being in a relationship was helpful). Also men had higher self-esteem than women. Those with higher levels of education, and those working or studying, had higher self-esteem than those who did not. RSES was found to have a single-factor structure. Conclusion: Deafness and partial deafness appear to be risk factors for lower self-esteem, a finding that rehabilitation, medical, educational, and employment communities should be made aware of. Medical intervention in the form of a CI supplies the person with improved hearing, but it is not a panacea: their self-esteem is still vulnerable, and reinforcement of self-esteem is an aspect that professionals should focus on. Psychological, psycho-educational, and psychotherapeutic interventions have important roles to play for CI recipients. [ABSTRACT FROM AUTHOR]

It has been reported that both click-evoked otoacoustic emissions (CEOAEs) and distortion product otoacoustic emissions (DPOAEs) have higher amplitudes in ears that possess spontaneous otoacoustic emissions (SOAEs). The general aim of the present study was to investigate whether the presence of spontaneous activity in the cochlea affected tone-burst evoked otoacoustic emissions (TBOAEs). As a benchmark, the study also measured growth functions of CEOAEs. Spontaneous activity in the cochlea was measured by the level of synchronized spontaneous otoacoustic emissions (SSOAEs), an emission evoked by a click but closely related to spontaneous otoacoustic emissions (SOAEs, which are detectable without any stimulus). Measurements were made on a group of 15 adults whose ears were categorized as either having recordable SSOAEs or no SSOAEs. In each ear, CEOAEs and TBOAEs were registered at frequencies of 0.5, 1, 2, and 4 kHz, and input/output functions were measured at 40, 50, 60, 70, and 80 dB SPL. Global and half-octave-band values of response level and latency were estimated. Our main finding was that in ears with spontaneous activity, TBOAEs had higher levels than in ears without. The difference was more apparent for global values, but were also seen with half-octave-band analysis. Input/output functions had similar growth rates for ears with and without SSOAEs. There were no significant differences in latencies between TBOAEs from ears with and without SSOAEs, although latencies tended to be longer for lower stimulus levels and lower stimulus frequencies. When TBOAE levels were compared to CEOAE levels, the latter showed greater differences between recordings from ears with and without SSOAEs. Although TBOAEs reflect activity from a more restricted cochlear region than CEOAEs, at all stimulus frequencies their behavior still depends on whether SSOAEs are present or not. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: The purpose of this study was to measure the degree of coupling between the floating mass transducer (FMT) and the round window membrane (RWM) in patients with conductive and mixed hearing loss implanted with the Vibrant Soundbridge (VSB) device. The efficiency of direct and indirect coupling of the FMT to the RWM was compared by measuring differences between the initial prescription targets and the final settings of the VSB audio processor after fine-tuning.Study Design: Retrospective study.Methods: Investigation of a group of subjects with either conductive or mixed hearing loss implanted with the VSB, a device that uses a FMT coupled to the RWM. There were two subgroups: subjects in which coupling was direct (no interposed material) or indirect (interposed material). The functional gain, insertion gain, and compression characteristics of the device were measured to assess the efficiency of coupling and to investigate the proximity of the fitting to prescriptive targets.Results: Coupling for the subgroup with indirect coupling of the RWM was higher (better) than for the subgroup with direct coupling. The gain deviation from prescriptive targets was smaller for the subgroup with indirect coupling.Conclusions: The coupling method can have an effect on the coupling efficiency and the final electroacoustic settings of the device. The prescription targets were not accurate for the majority of subjects from either subgroup. Indirect coupling appears to provide more effective stimulation of the cochlea.Level Of Evidence: 4. Laryngoscope, 127:2843-2849, 2017. [ABSTRACT FROM AUTHOR]

There is a limited number of diagnostic procedures to verify the presence of large vestibular aqueduct syndrome (LVAS) in humans. The wide-band absorbance (WBA) measurement technique is a non-invasive and objective tool for assessing the amount of sound energy absorbed by the tympanic membrane over a wide frequency range. We suggest that WBA could be an aid for detecting LVAS in some hearing-impaired subjects. We report use of WBA on a patient who had bilateral sensorineural hearing loss associated with LVAS and cochlear abnormalities in both ears. [ABSTRACT FROM AUTHOR]

Background: Distortion product otoacoustic emissions (DPOAEs) are most commonly measured up to 6 kHz. However, there are now systems available that can measure DPOAEs up to 16 kHz. The purpose of this study was to compare two such systems. Case report: One subject with hearing thresholds below 20 dB HL at frequencies from 0.125 to 16 kHz was used to compare DPOAEs measured by the two systems. The HearID+DP (Mimosa Acoustics) and SmartDPOAE (Intelligent Hearing Systems) were used. DPOAEs were measured at frequencies from 0.5 to 16 kHz. Short-time repeatability was assessed by comparing DPOAE amplitudes between two measurements, with the second measurement made after refitting the probe. DPOAEs were above the noise for all tested frequencies. Comparison of results from the two systems showed that the differences between consecutive measurements and between the two systems was lowest in the 1-8 kHz range and highest in the 9-16 kHz range. However, even in the 1-8 kHz range, differences between response levels averaged 4 dB. Conclusions: Both systems provided DPOAE levels that were consistent with normal hearing thresholds. However, the differences between the two systems were quite high and may be too large to detect small changes in cochlear status if different equipment is used. [ABSTRACT FROM AUTHOR]

Background: The effect of suppression of otoacoustic emissions (OAEs) by contralateral acoustic stimulation (CAS) is very small, on the level of 1-2 dB. At the same time, OAEs are known to have quite high variability across subjects and some fluctuation of the signal between measurements is also present. The purpose of the present study was to investigate short-term repeatability of contralateral suppression of transiently evoked OAEs (TEOAEs). Material and methods: OAEs were recorded in a group of 10 adults with normal hearing. TEOAEs were recorded using the linear protocol (all stimuli at the same level and polarity); stimulus levels were kept at 65 dB peSPL; and a 60 dB SPL broadband noise was delivered to the contralateral ear as suppressor. Each recording session consisted of three measurements: the first two were made consecutively without taking out the probe ('single fit' mode); the third measurement was made after taking out and refitting the probe ('multiple fit' mode). Global and half-octave values of TEOAE response levels and suppression were investigated. Additionally, as a measure of reliability, standard errors of measurement (SEMs) were analyzed. Results: Broadband suppression was on average around 0.9 dB, while in the three half-octave frequency bands between 1 and 2 kHz it was 1.2-0.9 dB, 0.6 dB for the 2.8 kHz band, and 0.4 dB for the 4 kHz band. The SEM of suppression for single fit mode was about 0.15 dB for broadband analysis and 0.3 dB for 1 kHz, 0.2 dB for 1.4-2 kHz, 0.3 dB for 2.8 kHz, and 0.4 dB for 4 kHz. For multiple fits, there were only minor differences in SEM between broadband and 1-2.8 kHz, while for 4 kHz the SEM was greater, reaching 0.5 dB. Conclusions: For a given paradigm, the reliability of suppression of TEOAEs is quite satisfactory for global values and for the 1-2 kHz bands. In this range, the SEM is smaller than the suppression effect. On the other hand, for higher frequencies, the variability is higher, about the same as the measured suppression. [ABSTRACT FROM AUTHOR]

Background/Aim: In this study, we carried out a retrospective analysis of the efficacy and toxicity of bendamustine in patients with B-cell lymphoproliferative diseases. Methods: Bendamustine was administered both as monotherapy and in combined protocols to 92 patients, including 76 patients with chronic lymphocytic leukemia (CLL) and 16 patients with indolent lymphomas. Bendamustine plus rituximab was used to treat 65.2% of the patients, and 34.8% of the patients received bendamustine as monotherapy. Results: The overall response rate was 64.2%, including the complete response rate (18.5%) and the partial response rate (45.7%). The median overall survival (OS) was 11.5 months. Among the pretreatment parameters, β2-microglobulin (RR = 1.413; p = 0.001) and hemoglobin levels (RR = 0.85; p = 0.03) significantly influenced survival. The OS was significantly longer in patients who received ≤2 lines of previous therapy compared to >3 lines (p = 0.043; log-rank test) and those who received ≥4 courses of therapy with bendamustine (p = 0.0007; log-rank test). Toxicity was predominantly hematological, including grade III/IV neutropenia in 33.7%, thrombocytopenia in 13%, and anemia in 13% of patients. Conclusion: Bendamustine, both in monotherapy and in combination regimens, is an effective therapy with a favorable toxicity profile in patients with indolent B-cell malignancies. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to investigate transiently evoked otoacoustic emissions recorded from the cochleas of neonates using three acquisition protocols: non-linear; linear; and QuickScreen. In the non-linear mode, a series of four clicks was used, with three clicks at the same level and polarity and a fourth at three times greater amplitude and inverted polarity. In the linear protocol, all stimuli were presented at the same level and polarity. Both modes used a 20 ms recording window, but the third QuickScreen screening mode used the non-linear click sequence and a shorter 12 ms window. MATERIALS and METHODS: All responses were processed off-line with time-frequency algorithms, with the linear transiently evoked otoacoustic emissions additionally processed to eliminate linear artifacts in the initial few milliseconds of signal. RESULTS: Short windows contained only a fraction of the transiently evoked otoacoustic emission, distorting its time-frequency structure. Analysis of the response level and signal to noise ratio suggested that recordings elicited by a linear protocol had an advantage in terms of signal to noise ratio. CONCLUSION: The results indicate that screening protocols that use recording windows with a reduced length, such as QuickScreen, can only be used to detect the presence or absence of otoacoustic emission. Removing the stimulus artifact from linear transiently evoked otoacoustic emission responses improves response level and signal to noise ratio compared with the standard non-linear protocol. [ABSTRACT FROM AUTHOR]

Background: In the present study otoacoustic emissions (OAEs) were used to evaluate the hearing of partial deafness subjects who had normal hearing up to 0.5 kHz and severe hearing loss above that frequency. The purpose of the study was to detect OAEs at 0.5 kHz and determine whether broad-band or band-limited values of OAE parameters were better for distinguishing ears with OAEs from those without. Material and Methods: The study group consisted of 15 subjects with high-frequency hearing loss above 0.5 kHz. For reference, a group of 15 subjects with severe to profound sensorineural hearing loss over the whole of the 0.125DS8 kHz range was used. In both groups, click-evoked OAEs (CEOAEs) and tone burst-evoked OAEs (TBOAEs) of 1 or 0.5 kHz were evaluated using a reproducibility parameter, taking into consideration broad-band, octave, and half-octave band values. Results: In the study group the best results were obtained by using 0.5 kHz TBOAEs. Clicks and 1 kHz tone bursts generally did not produce a response at 0.5 kHz. TBOAEs at 0.5 kHz enabled the separation of partially deaf ears from ears with severe hearing impairment. Half-octave band filtering yielded the best results; however, it was only slightly better than broadband and octave band filtering. Conclusions: The results of the study indicate that the 0.5 kHz TBOAE is a better stimulus than CEOAE and 1 kHz TBOAE when cochlear function at low frequency needs to be tested. The half-octave band seems the best choice in order to get frequency- specific information. However the results should be treated with caution since the studied groups were relatively small. [ABSTRACT FROM AUTHOR]

Click-evoked otoacoustic emissions (CEOAEs) are commonly recorded as average responses to a repetitive click stimulus. If the click train has constant polarity, a linear average results; if it contains a sequence of clicks of differing polarity and amplitude, a nonlinear average can be calculated. The purpose of this study was to record both protocols from the same set of ears and characterize the differences between them. The major features of CEOAEs were similar under both protocols with the exception of a region spanning 0-5 ms in time and 0-2.2 kHz in frequency. It was assumed that the signal derived from the linear protocol was contaminated by stimulus artifact, and so a simple procedure was used---involving high-pass filtering and time-windowing---to remove components of this artifact. This procedure preserved the short-latency, high-frequency responses; it also produced a marked similarity in the time-frequency plots of recordings made under the two protocols. This result means it is possible to take advantage of the better signal-to-noise ratio of the linear data compared to its nonlinear counterpart. Additionally, it was shown that CEOAEs recorded under the linear protocol appear to be less dependent on the presence of spontaneous otoacoustic emissions (SOAEs). [ABSTRACT FROM AUTHOR]

Transiently evoked otoacoustic emissions (TEOAEs) are normally modeled as the sum of asymmetric waveforms. However, some previous studies of TEOAEs used time-frequency (TF) methods to decompose the signals into symmetric waveforms. This approach was justified mainly as a means to reduce the complexity of the calculations. The present study extended the dictionary of numeric functions to incorporate asymmetric waveforms into the analysis. The necessary calculations were carried out using an adaptive approximation algorithm based on the matching pursuit (MP) numerical technique. The classic MP dictionary uses Gabor functions and consists of waveforms described by five parameters, namely, frequency, latency, time span, amplitude, and phase. In the present investigation, a sixth parameter, the degree of asymmetry, was added in order to enhance the flexibility of this approach. The effects of expanding the available functions were evaluated by means of both simulations using synthetic signals and authentic TEOAEs. The resulting analyses showed that the contributions of asymmetric components in the OAE signal are appreciable. In short, the expanded analysis method brought about important improvements in identifying TEOAE components including the correct detection of components with long decays, which are often related to spontaneous OAE activity, the elimination of a “dark energy” effect in TF distributions, and more reliable estimates of latency-frequency relationships. The latter feature is especially important for correct estimation of latency-frequency data, which is a crucial factor in investigations of OAE-generation mechanisms. [ABSTRACT FROM AUTHOR]

The aim of this research is to extend previous studies of the time-frequency features of otoacoustic emissions (OAEs) using information about the properties of the signals at low frequencies. Responses to 0.5 kHz tone bursts were compared to OAEs that were evoked by click stimuli and by 1, 2, and 4 kHz tone burst stimuli. The OAEs were measured using 20 and 30 ms intervals between stimuli. The analysis revealed no differences in the time-frequency properties of 1, 2, and 4 kHz bursts measured using these two different acquisition windows. However, at 0.5 kHz the latency of the response was affected significantly if a shorter time window was used. This was caused by the fact that the response reached a maximum after an average time of 15.4 ms, and lasted a few milliseconds longer. Therefore, for this particular stimulus, the use of a 30 ms time window seems more appropriate. In addition, as an example of the possible application of low-frequency OAEs, signals were measured in patients suffering from partial deafness, characterized by steep audiograms with normal thresholds up to 0.5 kHz and almost total deafness above this frequency. Although no response to clicks was observed in these subjects, the use of 0.5 kHz tone bursts did produce OAEs. [ABSTRACT FROM AUTHOR]

A synchronized spontaneous otoacoustic emission paradigm was used to measure the response in time intervals of 80 ms following a click stimulus. The responses obtained were decomposed into basic waveforms by means of adaptive approximations using a matching pursuit algorithm. High-resolution time-frequency distributions of signal energy were calculated and showed three types of component: (1) purely evoked of duration less than 5 ms, (2) longer lasting and decaying, with exponentially decreasing amplitude, and (3) long lasting and stable. The distributions of the frequencies of components of different durations were similar, with most components falling within the 1–2 kHz interval. It is shown that the presence of long-lasting components may influence the estimation of the latency of evoked emissions, especially at higher frequencies where the evoked part has a very short duration. [ABSTRACT FROM AUTHOR]