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Background: This study examined electrical bioimpedance as a biomarker for intracochlear tissue changes after cochlear implant surgery, comparing monopolar, three-point, and four-point impedance measurements over time and evaluating different measurement systems and approaches. Methods: Impedance measurements were obtained from 21 participants during surgery and at four postoperative stages. Monopolar impedances were recorded using the Bionic Ear Data Collection System (BEDCS) and the Active Insertion Monitoring (AIM) system. Three- and four-point impedances were recorded directly using BEDCS, and indirect three-point impedances were additionally derived from Electrical Field Imaging matrices recorded using BEDCS or AIM. Results: There was an 11% relative error between monopolar measurements from BEDCS and AIM and a 25% discrepancy between direct and indirect three-point measurements. Despite this, direct and indirect measurements from both systems were useful for tracking postoperative impedance shifts. Three- and four-point measurements showed a strong relationship both during and after surgery. Our results suggest that three- and four-point measurements are more specific than monopolar impedances in capturing localized tissue changes. Conclusions: Three- and four-point impedance measurements are potential markers of intracochlear tissue changes over time. While direct three-point impedance measurements offer higher accuracy, indirect measurements provide a feasible alternative for monitoring intracochlear changes in clinical settings lacking the option of direct measurements. [ABSTRACT FROM AUTHOR]

Objectives. FDXR encodes mitochondrial ferredoxin reductase, which is associated with auditory neuropathy spectrum disorder (ANSD) and optic atrophy. To date, only two studies have described FDXR-related hearing loss. The auditory rehabilitation outcomes of this disease entity have not been investigated, and the pathophysiological mechanisms remain incompletely understood. Here we report a hearing-impaired individual with co-segregation of the FDXR variant and post-synaptic type ANSD, who underwent cochlear implantation (CI) with favorable outcomes. We suggest a possible pathophysiological mechanism of adult-onset ANSD involving mitochondrial dysfunction. Methods. A 35-year-old woman was ascertained to have ANSD. Exome sequencing identified the genetic cause of hearing loss, and a functional study measuring mitochondrial activity was performed to provide molecular evidence of pathophysiology. Expression of FDXR in the mouse cochlea was evaluated by immunohistochemistry. Intraoperatively, electrically evoked compound action potential (ECAP) responses were measured, and the mapping parameters were adjusted accordingly. Audiological outcomes were monitored for over 1 year. Results. In lymphoblastoid cell lines (LCLs) carrying a novel FDXR variant, decreased ATP levels, reduced mitochondrial membrane potential, and increased reactive oxygen species levels were observed compared to control LCLs. These dysfunctions were restored by administering mitochondria isolated from umbilical cord mesenchymal stem cells, confirming the pathogenic potential of this variant via mitochondrial dysfunction. Partial ECAP responses during CI and FDXR expression in the mouse cochlea indicate that FDXR-related ANSD is post-synaptic. As a result of increasing the pulse width during mapping, the patient’s CI outcomes showed significant improvement over 1-year post-CI. Conclusion. A novel FDXR variant associated with mitochondrial dysfunction and post-synaptic ANSD was first identified in a Korean individual. Additionally, 1-year post-CI outcomes were reported for the first time in the literature. Excellent audiologic results were obtained, and our results reiterate the correlation between genotype and CI outcomes in ANSD.

The use of in-situ audiometry for hearing aid fitting is appealing due to its reduced resource and equipment requirements compared to standard approaches employing conventional audiometry alongside real-ear measures. However, its validity has been a subject of debate, as previous studies noted differences between hearing thresholds measured using conventional and in-situ audiometry. The differences were particularly notable for open-fit hearing aids, attributed to low-frequency leakage caused by the vent. Here, in-situ audiometry was investigated for six receiver-in-canal hearing aids from different manufacturers through three experiments. In Experiment I, the hearing aid gain was measured to investigate whether corrections were implemented to the prescribed target gain. In Experiment II, the in-situ stimuli were recorded to investigate if corrections were directly incorporated to the delivered in-situ stimulus. Finally, in Experiment III, hearing thresholds using in-situ and conventional audiometry were measured with real patients wearing open-fit hearing aids. Results indicated that (1) the hearing aid gain remained unaffected when measured with in-situ or conventional audiometry for all open-fit measurements, (2) the in-situ stimuli were adjusted for up to 30 dB at frequencies below 1000 Hz for all open-fit hearing aids except one, which also recommends the use of closed domes for all in-situ measurements, and (3) the mean interparticipant threshold difference fell within 5 dB for frequencies between 250 and 6000 Hz. The results clearly indicated that modern measured in-situ thresholds align (within 5 dB) with conventional thresholds measured, indicating the potential of in-situ audiometry for remote hearing care. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is a frequent congenital condition. If not treated promptly, the disease’s progression may endanger newborns and young children’s proper growth and development. Cochlear implants (CIs) are the only viable treatment for severe or extremely severe sensorineural hearing loss. Aims and Objectives: This study aimed to see how auditory performance and speech development changed after cochlear implantation in children born deaf and whether there is a link between sociodemographic parameters and the outcome. Materials and Methods: Analyze the improvement of speech and auditory performance in congenitally deaf children aged 1–6 years who underwent CI surgery at Government Rajaji Hospital, Madurai Medical College, Madurai, from January 2016 to June 2018. The data acquired in this study were statistically analyzed to provide detailed findings. Results: Among the study population with age distribution, 18 (26.87%) were in 3 years, followed by 17 (25.37%) in 4 years and least 1 (1.49%) were in 1 year. Sex distribution – 42 (62.69%) were male, and 25 (37.31%) were female children. Progress in hearing and speech was observed, which was evident from the 2-year assessment of categories of auditory performance (CAP) (2.7–4.4) and speech intelligibility rating (SIR) scores (1.04–3.67), increasing every 3 months (P

Cochlear implantation successfully improves hearing in most adult recipients. However, in rare cases, post-implant rehabilitation is required to maximize benefit. The primary aim of this investigation was to test if self-reports by cochlear implant users indicate the need for post-implant rehabilitation. Listening performance was assessed with the Speech, Spatial and Qualities short-form SSQ12, which was self-administered via a web-based survey. Subjects included over 2000 adult bilateral or unilateral cochlear implant users with at least one year of experience. A novel application of regression tree analysis identified core SSQ12 items that serve as first steps in establishing a plan for further rehabilitation: items 1, 8, and 11 dealing with single-talker situations, loudness perception, and clarity, respectively. Further regression and classification tree analyses revealed that SSQ12 item scores were weakly related to age, degree of tinnitus, and use of bilateral versus unilateral implants. Conversely, SSQ12 scores were strongly associated with self-rated satisfaction and confidence in using their cochlear implant. The SSQ12 total scores did not vary significantly over 1–9 or more years' experience. These findings suggest that the SSQ12 may be a useful tool to guide rehabilitation at any time after cochlear implantation. Identification of poor performance may have implications for timely management to improve the outcomes, through various techniques such as device fitting adjustments, counseling, active sound exposure, and training spatial hearing. [ABSTRACT FROM AUTHOR]

Tinnitus is prevalent among military Veterans, yet there is a gap between the demand and the provision of services for tinnitus rehabilitation services within the Veterans Health Administration (VHA). We sought to understand tinnitus rehabilitation service needs and preferences among Veterans with bothersome tinnitus who use Veterans Affairs (VA) services. We conducted semistructured telephone interviews in 2019 with Veterans diagnosed with tinnitus, who reported it as bothersome. Veterans were purposively sampled to represent national VA users, with and without comorbid traumatic brain injury (TBI), and who were or were not interested in tinnitus rehabilitation services. Qualitative data were analyzed using a modified grounded theory approach. Among 40 Veterans interviewed (32 men, 8 women; 50% with TBI), 72.5% endorsed being somewhat/very likely to be interested in tinnitus rehabilitation services while 27.5% were very/somewhat unlikely. Themes related to Veterans' interest in tinnitus rehabilitation services included barriers and facilitators to participation and preferences for receiving tinnitus services (e.g., individual vs. group-based; in-person vs. remote access). Our findings highlight factors that influence Veterans' reported need and preferences for, and readiness to engage in, rehabilitation services for tinnitus. Personalized or otherwise adaptable approaches to program delivery may help ensure maximal uptake among Veterans. [ABSTRACT FROM AUTHOR]

Recent research has found that practicing speech-language pathologists report feeling underprepared to provide services for individuals with hearing loss. At the same time, graduate SLP programs report that students have fewer training opportunities with low-incidence populations. This study examines learning outcomes for a cohort of graduate SLP students using a novel application of an immersive, augmented reality, hearing loss simulation. Results show encouraging outcomes for the simulation experience’s effects on empathy, knowledge, and clinical skills. This simulation offers a unique way to provide training related to auditory rehabilitation in SLP. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has affected numerous aspects of human existence, thus increasing psychological stress in the overall population worldwide. Healthcare and social support systems have suffered extreme challenges and pressures. The welfare, protection, and rights of socially vulnerable groups, such as children with loss of hearing and their families, were challenged. The system of auditory rehabilitation encountered numerous problems due to the Covid-19 pandemic, because of the compromised access to rehabilitation facilities and therapists. The objective of the study was to investigate the parents’ perspective on the influence of the Covid-19 pandemic on auditory rehabilitation. A questionnaire was developed to gather the parents’ answers to the research questions. The sample consisted of fifty-one parents of deaf children and children hard of hearing enrolled in the auditory rehabilitation process. The results showed a considerable impact of the pandemic on the accessibility of rehabilitation, with periods of two to three months of complete disruption for most children, due to lockdown. A vast number of parents experienced psychological stress due to those changes, accompanied by the fear of contracting Covid-19 when attending rehabilitation facilities. Most of the parents observed changes in their child’s behaviour, and communication difficulties due to face masks during the pandemic. Numerous studies support these findings. The results of our research show that the improvement and an increase in the flexibility of the auditory rehabilitation system are necessary. Auditory rehabilitation should be supported by stateof-the-art technologies (e.g., telecommunication) in order to ensure the continuity of the rehabilitation process and support for hearing-impaired children and their parents, even in extreme circumstances. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is a frequent congenital condition. If not treated promptly, the disease's progression may endanger newborns and young children's proper growth and development. Cochlear implants (CIs) are the only viable treatment for severe or extremely severe sensorineural hearing loss. Aims and Objectives: This study aimed to see how auditory performance and speech development changed after cochlear implantation in children born deaf and whether there is a link between sociodemographic parameters and the outcome. Materials and Methods: Analyze the improvement of speech and auditory performance in congenitally deaf children aged 1-6 years who underwent CI surgery at Government Rajaji Hospital, Madurai Medical College, Madurai, from January 2016 to June 2018. The data acquired in this study were statistically analyzed to provide detailed findings. Results: Among the study population with age distribution, 18 (26.87%) were in 3 years, followed by 17 (25.37%) in 4 years and least 1 (1.49%) were in 1 year. Sex distribution - 42 (62.69%) were male, and 25 (37.31%) were female children. Progress in hearing and speech was observed, which was evident from the 2-year assessment of categories of auditory performance (CAP) (2.7-4.4) and speech intelligibility rating (SIR) scores (1.04-3.67), increasing every 3 months (P<0.001). Scores of children in age group 2 (CAP2 and SIR 3.3) were the highest, yet differed significantly among age groups, implying that the earlier the CI implantation age, the better their language outcomes were. Conclusion: The importance of age at implantation and the role of family members in effective audioverbal therapy and aural stimulation at home were highlighted in this study. [ABSTRACT FROM AUTHOR]

This study aimed to explore perceptions and experiences about how owning a hearing dog can influence the functioning and the autonomy of people with hearing loss. Three adults participated in a semi-structured interview. The interviews were video recorded, transcribed, and coded. A procedure combining qualitative content analysis and interpretative phenomenological analysis was used. The study shows how specific aspects of hearing dogs are associated with increased autonomy and sense of security among owners. The attentive dog-owner pairing, the outstanding training and the companion role of the hearing dog are the main elements supporting the high satisfaction related by all the participants. In regard of the location context (Quebec, Canada), ongoing challenges for owners are reflected in the lack of visibility of this rehabilitation means and its poor recognition from the society, resulting in the constant burden to explain the dog’s work to others. For adults with hearing loss, the hearing dog is a relevant way of offering both the benefits of functional assistance and the psychosocial support of a pet. The association between owning a hearing dog and improved overall well-being suggests that this form of rehabilitation should be considered as a pertinent option by hearing health professionals.

Acoustic-phonetic speech training mitigates confusion between consonants and improves phoneme identification in noise. A novel training paradigm addressed two principles of perceptual learning. First, training benefits are often specific to the trained material; therefore, stimulus variability was reduced by training small sets of phonetically similar consonant–vowel–consonant syllables. Second, the training is most efficient at an optimal difficulty level; accordingly, the noise level was adapted to the participant’s competency. Fifty-two adults aged between sixty and ninety years with normal hearing or moderate hearing loss participated in five training sessions within two weeks. Training sets of phonetically similar syllables contained voiced and voiceless stop and fricative consonants, as well as voiced nasals and liquids. Listeners identified consonants at the onset or the coda syllable position by matching the syllables with their orthographic equivalent within a closed set of three alternative symbols. The noise level was adjusted in a staircase procedure. Pre–post-training benefits were quantified as increased accuracy and a decrease in the required signal-to-noise ratio (SNR) and analyzed with regard to the stimulus sets and the participant’s hearing abilities. The adaptive training was feasible for older adults with various degrees of hearing loss. Normal-hearing listeners performed with high accuracy at lower SNR after the training. Participants with hearing loss improved consonant accuracy but still required a high SNR. Phoneme identification improved for all stimulus sets. However, syllables within a set required noticeably different SNRs. Most significant gains occurred for voiced and voiceless stop and (af)fricative consonants. The training was beneficial for difficult consonants, but the easiest to identify consonants improved most prominently. The training enabled older listeners with different capabilities to train and improve at an individual ‘edge of competence’.

Background: The outcome of cochlear implantation has improved over the last decades, but there are still patients with less benefit. Despite numerous studies examining the cochlear implant (CI) outcome, variations in speech comprehension with CI remains incompletely explained. The aim of this study was therefore to examine preoperative pure-tone audiogram and speech comprehension as well as aetiology, to investigate their relationship with postoperative speech comprehension in CI recipients. Methods: A retrospective study with 664 ears of 530 adult patients was conducted. Correlations between the target variable postoperative word comprehension with the preoperative speech and sound comprehension as well as aetiology were investigated. Significant correlations were inserted into multivariate models. Speech comprehension measured as word recognition score at 70 dB with CI was analyzed as (i) a continuous and (ii) a dichotomous variable. Results: All variables that tested preoperative hearing were significantly correlated with the dichotomous target; with the continuous target, all except word comprehension at 65 dB with hearing aid. The strongest correlation with postoperative speech comprehension was seen for monosyllabic words with hearing aid at 80 dB. The preoperative maximum word comprehension was reached or surpassed by 97.3% of CI patients. Meningitis and congenital diseases were strongly negatively associated with postoperative word comprehension. The multivariate model was able to explain 40% of postoperative variability. Conclusion: Speech comprehension with hearing aid at 80 dB can be used as a supplementary preoperative indicator of CI-aided speech comprehension and should be measured regularly in the clinical routine. Combining audiological and aetiological variables provides more insights into the variability of the CI outcome, allowing for better patient counselling. [ABSTRACT FROM AUTHOR]

Ethical standards in audiology have been continuously improved and discussed, leading to the elaboration of specific regulatory guidelines for the profession. However, in the field of auditory rehabilitation, audiologists are still faced with circumstances that question their ethical principles, usually associated with the support of the hearing aids industry. The study explores the decision-making process and ethical concerns in auditory rehabilitation as they relate to the practice of audiology in Portugal. An online questionnaire constructed by the authors was used and sent to the email addresses of a list of audiologists, registered with the Portuguese Association of Audiologists. The questionnaire was answered by 93 audiologists with clinical experience in auditory rehabilitation for more than one year. The collected data demonstrated that audiometric results and clinical experience are the most important factors for decision-making in auditory rehabilitation practice. Moreover, incentives from the employers or manufacturers were identified as the main cause of ethical dilemmas. This study highlights the ethical concerns regarding the clinical practice of auditory rehabilitation in Portugal, revealing that the decision-making process is complex and, specifically in this field, the current practice may not be adequate for effective compliance with professional ethical standards.

This study aimed to explore perceptions and experiences about how owning a hearing dog can influence the functioning and the autonomy of people with hearing loss. Three adults participated in a semi-structured interview. The interviews were video recorded, transcribed, and coded. A procedure combining qualitative content analysis and interpretative phenomenological analysis was used. The study shows how specific aspects of hearing dogs are associated with increased autonomy and sense of security among owners. The attentive dog-owner pairing, the outstanding training and the companion role of the hearing dog are the main elements supporting the high satisfaction related by all the participants. In regard of the location context (Quebec, Canada), ongoing challenges for owners are reflected in the lack of visibility of this rehabilitation means and its poor recognition from the society, resulting in the constant burden to explain the dog's work to others. For adults with hearing loss, the hearing dog is a relevant way of offering both the benefits of functional assistance and the psychosocial support of a pet. The association between owning a hearing dog and improved overall well-being suggests that this form of rehabilitation should be considered as a pertinent option by hearing health professionals. [ABSTRACT FROM AUTHOR]

Introduction: Auditory rehabilitation with a cochlear implant (CI), in many cases, positively impacts tinnitus. However, it is unclear if the tinnitus-related benefit of CI is equal for patients with various indications for CI. Therefore, this study aimed to determine differences in tinnitus prevalence and distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities between patients diagnosed with asymmetric hearing loss (AHL), single-sided (unilateral) deafness (SSD), and double-sided (bilateral) deafness (DSD) before and six months after cochlear implantation. Methods: One hundred-one CI candidates were included in this prospective study (39 AHL patients, 23 DSD patients, and 39 SSD patients). The patients completed questionnaires measuring tinnitus distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities before and 6 months after CI. Results: The prevalence of tinnitus in the entire cohort (80.2% before CI) decreased 6 months after CI to 71.3%. The DSD group had the lowest tinnitus prevalence at both time points. The degree of tinnitus-induced distress decreased significantly in all three groups after CI. Differences in quality of life, subjective hearing, and psychological comorbidities between the groups at the study onset disappeared after CI. Significant correlations existed between anxiety, depression, and tinnitus distress in AHL and SSD but not in DSD patients before and after CI. Discussion: Our results demonstrate significant differences between the three groups of CI candidates, which might affect the implantation outcome. These differences suggest a need for personalized psychological counseling during the auditory rehabilitation process, focusing on anxiety and depressive symptoms for SSD and AHL patients. [ABSTRACT FROM AUTHOR]

Acoustic-phonetic speech training mitigates confusion between consonants and improves phoneme identification in noise. A novel training paradigm addressed two principles of perceptual learning. First, training benefits are often specific to the trained material; therefore, stimulus variability was reduced by training small sets of phonetically similar consonant–vowel–consonant syllables. Second, the training is most efficient at an optimal difficulty level; accordingly, the noise level was adapted to the participant's competency. Fifty-two adults aged between sixty and ninety years with normal hearing or moderate hearing loss participated in five training sessions within two weeks. Training sets of phonetically similar syllables contained voiced and voiceless stop and fricative consonants, as well as voiced nasals and liquids. Listeners identified consonants at the onset or the coda syllable position by matching the syllables with their orthographic equivalent within a closed set of three alternative symbols. The noise level was adjusted in a staircase procedure. Pre–post-training benefits were quantified as increased accuracy and a decrease in the required signal-to-noise ratio (SNR) and analyzed with regard to the stimulus sets and the participant's hearing abilities. The adaptive training was feasible for older adults with various degrees of hearing loss. Normal-hearing listeners performed with high accuracy at lower SNR after the training. Participants with hearing loss improved consonant accuracy but still required a high SNR. Phoneme identification improved for all stimulus sets. However, syllables within a set required noticeably different SNRs. Most significant gains occurred for voiced and voiceless stop and (af)fricative consonants. The training was beneficial for difficult consonants, but the easiest to identify consonants improved most prominently. The training enabled older listeners with different capabilities to train and improve at an individual 'edge of competence'. [ABSTRACT FROM AUTHOR]

IntroductionAuditory rehabilitation with a cochlear implant (CI), in many cases, positively impacts tinnitus. However, it is unclear if the tinnitus-related benefit of CI is equal for patients with various indications for CI. Therefore, this study aimed to determine differences in tinnitus prevalence and distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities between patients diagnosed with asymmetric hearing loss (AHL), single-sided (unilateral) deafness (SSD), and double-sided (bilateral) deafness (DSD) before and six months after cochlear implantation.MethodsOne hundred-one CI candidates were included in this prospective study (39 AHL patients, 23 DSD patients, and 39 SSD patients). The patients completed questionnaires measuring tinnitus distress, health-related quality of life, subjective hearing, perceived stress, and psychological comorbidities before and 6 months after CI.ResultsThe prevalence of tinnitus in the entire cohort (80.2% before CI) decreased 6 months after CI to 71.3%. The DSD group had the lowest tinnitus prevalence at both time points. The degree of tinnitus-induced distress decreased significantly in all three groups after CI. Differences in quality of life, subjective hearing, and psychological comorbidities between the groups at the study onset disappeared after CI. Significant correlations existed between anxiety, depression, and tinnitus distress in AHL and SSD but not in DSD patients before and after CI.DiscussionOur results demonstrate significant differences between the three groups of CI candidates, which might affect the implantation outcome. These differences suggest a need for personalized psychological counseling during the auditory rehabilitation process, focusing on anxiety and depressive symptoms for SSD and AHL patients.

Cognitive function and hearing are known to both decline in older adults. As hearing loss is proposed to be one modifiable risk factor for dementia, the impact of auditory rehabilitation on cognitive decline has been gaining increasing attention. Despite a large number of studies, long-term data are still rare. In a large prospective longitudinal monocentric study, 50 adults (aged ≥ 50 years) with severe postlingual bilateral hearing loss received a cochlear implant (CI). They underwent comprehensive neurocognitive testing prior to implantation (T1), at 12 months (T2) and up to 65 months (T3) after implantation. Various cognitive subdomains such as attention, inhibition, working memory, verbal fluency, mental flexibility and (delayed) recall were assessed by the computer-based non-auditory test battery ALAcog©. The observed trajectories of two exemplary cognitive subdomains (delayed recall and working memory) were then fitted over time using multilevel growth models to adjust for sociodemographic covariates and compared with 5-year longitudinal data from a sample of older adults from the representative Survey of Health, Aging and Retirement in Europe (SHARE) study. Postoperatively, auditory functions improved from 6.98% (SD 12.83) to 57.29% (SD 20.18) in monosyllabic speech understanding. Cognitive functions significantly increased from T1 to T3 in attention (p = 0.001), delayed recall (p = 0.001), working memory (OSPAN; p = 0.001), verbal fluency (p = 0.004), and inhibition (p = 0.002). A closer look at follow-up revealed that cognitive improvement could be detected between T1 and T2 and thereafter remained stable in all subtests (p ≥ 0.06). Additional longitudinal analysis confirmed these findings in a rigorous multilevel approach in two exemplary cognitive subdomains. In contrast to the SHARE data, there was no evidence for age-differential associations over time in CI recipients. This suggests that older adults benefit equally from cochlear implantation. CI users with worse preoperative cognitive skills experienced the most benefit (p < 0.0001). Auditory rehabilitation by cochlear implantation has a stimulating effect on cognitive functions beyond an improvement in speech understanding and an increased well-being. Large multicenter studies using standardized protocols have to be undertaken in the future to find out whether hearing restoration might help to prevent cognitive decline. [ABSTRACT FROM AUTHOR]

Abstract Background There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant. Methods This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e. placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study. Results The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients. Discussion We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12619000609156 . Registered on April 23 2019.

Objective: Our study aimed to measure the effectiveness of using HA in reducing the disturbance caused by tinnitus. Methods: Study was designed as a within-subjects clinical trial. Nineteen patients with chronic tinnitus and untreated sensorineural hearing loss were under counseling, HA fitting and 6 months follow-up. Tinnitus assessment was performed with Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), pitch and loudness matching, and Minimum Masking Level measurements (MML). Results: following 6 months of HA use, a reduction in reported tinnitus and hearing handicap scales scores was observed both statistically and clinically. The pitch and loudness matching, as well as MML at the baseline and final evaluation were compared. MML’s thresholds reduced significantly after 6 months of HA use. Conclusion: Our study has provided evidence that HA fitting is a valuable treatment strategy for chronic tinnitus relief and associated hearing loss subtype of patient. Level of evidence: 3.

Cognitive function and hearing are known to both decline in older adults. As hearing loss is proposed to be one modifiable risk factor for dementia, the impact of auditory rehabilitation on cognitive decline has been gaining increasing attention. Despite a large number of studies, long-term data are still rare. In a large prospective longitudinal monocentric study, 50 adults (aged ≥ 50 years) with severe postlingual bilateral hearing loss received a cochlear implant (CI). They underwent comprehensive neurocognitive testing prior to implantation (T1), at 12 months (T2) and up to 65 months (T3) after implantation. Various cognitive subdomains such as attention, inhibition, working memory, verbal fluency, mental flexibility and (delayed) recall were assessed by the computer-based non-auditory test battery ALAcog©. The observed trajectories of two exemplary cognitive subdomains (delayed recall and working memory) were then fitted over time using multilevel growth models to adjust for sociodemographic covariates and compared with 5-year longitudinal data from a sample of older adults from the representative Survey of Health, Aging and Retirement in Europe (SHARE) study. Postoperatively, auditory functions improved from 6.98% (SD 12.83) to 57.29% (SD 20.18) in monosyllabic speech understanding. Cognitive functions significantly increased from T1 to T3 in attention (p = 0.001), delayed recall (p = 0.001), working memory (OSPAN; p = 0.001), verbal fluency (p = 0.004), and inhibition (p = 0.002). A closer look at follow-up revealed that cognitive improvement could be detected between T1 and T2 and thereafter remained stable in all subtests (p ≥ 0.06). Additional longitudinal analysis confirmed these findings in a rigorous multilevel approach in two exemplary cognitive subdomains. In contrast to the SHARE data, there was no evidence for age-differential associations over time in CI recipients. This suggests that older adults benefit equally from cochlear implantation. CI users with worse preoperative cognitive skills experienced the most benefit (p < 0.0001). Auditory rehabilitation by cochlear implantation has a stimulating effect on cognitive functions beyond an improvement in speech understanding and an increased well-being. Large multicenter studies using standardized protocols have to be undertaken in the future to find out whether hearing restoration might help to prevent cognitive decline.

Background: congenital severe to profound sensorineural hearing loss (SP-SNHL) causes serious difficulties in production and comprehension of speech, necessitates use of a thorough rehabilitation program at early age. The aim of this study was to evaluate the relationship between hearing thresholds and the result of auditory rehabilitation in children with bilateral congenital SP-SNHL. Methods: This is a retrospective study. Thirty-five children (23 males and 12 females) with bilateral congenital SP-SNHL were evaluated based on Auditory Steady-State Response (ASSR). The mean age of children at the beginning of rehabilitation was 37.36 (±17.10) months. They received bilateral superpower hearing aids and auditory rehabilitation based on Auditory-Verbal Therapy (AVT) approach. Their Speech production and comprehension were assessed at the beginning and end of rehabilitation via Speech Intelligibility Rating (SIR) and Categories of Auditory Performance (CAP). Results: The SIR and CAP scores showed improvement in 12 (34.3%) and 25 (71.4%) children, respectively. These children had lower ASSR thresholds in 0.5 to 4 k Hz relative to others. The mean ASSR thresholds were 85.63 to 97.50 versus 96.09 to 104.75 (p < 0.05). Also, lower hearing thresholds were related to better results in auditory rehabilitation (p < 0.05). Conclusion: Lower hearing thresholds in children with SP-SNHL are associated with better rehabilitation results.

Objective:This study aimed to analyze the effectiveness of the Turkish matrix sentence test in evaluating the speech recognition performance of hearing aid users under different noise conditions.Methods:Speech recognition performance of 42 individuals, 20 to 65 years of age (mean 49.1±14 years) with bilateral sensorineural hearing loss was measured in noise with the Turkish matrix sentence test without a background noise and with headphones. Additionally, the participants’ speech recognition thresholds were measured with a matrix test while wearing their hearing aid under three different listening conditions in which the phases of speech and noise stimuli were changed with constant and fluctuating noise.Results:Speech-recognition thresholds were better in fluctuating noise than in constant noise in all listening conditions, and this difference was statistically significant (p=0.02). In both types of noise, speech-recognition thresholds of bilateral hearing aid users (n=29) were lower (better) than those of unilateral hearing aid users (n=13) under three different listening conditions, but there was no statistically significant difference (p=0.67). Speech-recognition thresholds without hearing aids were statistically higher (worse) than those obtained with hearing aids (p=0.001).Conclusion:Since the Turkish matrix sentence test gives useful results, this test can be used in the diagnosis, follow-up, and rehabilitation planning of hearing aid users. We observed that speech intelligibility was better, although there were differences among those with hearing loss when the speech test was conducted in fluctuating background noise with the Turkish matrix sentence test.

Abstract Background Children with hearing impairment are deprived of their source of linguistic input which in turn leads to linguistic and prosodic deficits that negatively affect language and social development. Linguistic aspects other than prosody have received considerable attention in studies concerned with hearing-impaired children with little literature addressing how to improve their affective prosodic deficits. The aim of the current study is to adapt and apply the “prosody treatment program” and detect the effect of prosodic rehabilitation on affect production and language development in Egyptian hearing-impaired children. This study was conducted on 21 children with sensorineural hearing loss. The subjects were randomly divided into two groups, group A (cases) and group B (control) by block randomization. The subjects of the study were evaluated pre and post-therapy by a protocol for assessment of their prosodic skills using subjective and objective measures. Both groups received the usual auditory and language rehabilitation therapy. The case group additionally received rehabilitation for prosody using the “prosody treatment program” for 3 months. Results Results showed a statistically significant improvement in the subjective scores and most of the objective scores of the assessed affective prosodic skills when comparing pre-therapy and post-therapy scores in the cases group, and when comparing both studied groups post-therapy. Conclusions Prosodic training has an additional benefit evident in improving affective prosodic skills of hearing-impaired children compared to conventional therapy alone with a positive effect on their linguistic development. Trial registration The trial is registered at www.clinicaltrials.gov NCT04691830 . Registered under the name “Adaptation of a Rehabilitation Program for Prosody and its Application on Egyptian Hearing Impaired Children”. Retrospectively registered:

IntroductionHearing loss has a great impact on the people affected, their close partner and the interaction between both, as oral communication is restricted. Nonverbal communication, which expresses emotions and includes implicit information on interpersonal relationship, has rarely been studied in people with hearing impairment (PHI). In psychological settings, non-verbal synchrony of body movements in dyads is a reliable method to study interpersonal relationship.Material and methodsA 10-min social interaction was videorecorded in 39 PHI (29 spouses and 10 parent-child dyads) and their significant others (SOs). Nonverbal synchrony, which means the nonverbal behaviors of two interacting persons (referring to both general synchrony and the role of leading) and verbal interaction (percentage of speech, frequency of repetitions, and queries) were analyzed by computer algorithms and observer ratings. Hearing-related quality of life, coping mechanisms, general psychopathology, quality of relationship, and burden of hearing loss experienced by SOs were assessed using questionnaires.ResultsIn the 39 dyads, true nonverbal synchrony differed from pseudosynchrony [t(43.4) = 2.41; p = 0.02] with a medium effect size (d = 0.42). Gender of PHI had a significant effect on general synchrony (p = 0.025) and on leading by SOs (p = 0.017). Age gap correlated with synchronic movements (p = 0.047). Very short duration of hearing impairment was associated with lower nonverbal synchrony in the role of leading by SOs (p = 0.031). Feeling of closeness by PHI correlated negatively with the role of leading by SOs (p > 0.001) and feeling of closeness by SOs was positively associated with leading by PHI (p = 0.015). No correlation was detected between nonverbal synchrony and other questionnaires. Burden experienced by the SOs was higher in SOs who reported less closeness (p = 0.014).DiscussionA longer hearing impairment leads to more nonverbal leading by SOs compared to PHI with very short duration of hearing loss, possibly because of the long-lasting imbalance in communication. If PHI felt more closeness, SOs led less and vice versa. Burden experienced by SOs negatively correlated with closeness reported by SOs. Use of nonverbal signals and communication might help to improve benefits of auditory rehabilitation for PHI and decrease burden experienced by SOs.

Listening in noise remains challenging for adults with cochlear implants (CI) even after prolonged experience. Personalized auditory training (AT) programs can be proposed to improve specific auditory skills in adults with CI. The objective of this study was to assess serious gaming as a rehabilitation tool to improve speech-in-noise intelligibility in adult CI users. Thirty subjects with bilateral profound hearing loss and at least 9 months of CI experience were randomized to participate in a 5-week serious game-based AT program (n = 15) or a control group (n = 15). All participants were tested at enrolment and at 5 weeks using the sentence recognition-in-noise matrix test to measure the signal-to-noise ratio (SNR) allowing 70% of speech-in-noise understanding (70% speech reception threshold, SRT70). Thirteen subjects completed the AT program and nine of them were re-tested 5 weeks later. The mean SRT70 improved from 15.5 dB to 11.5 dB SNR after 5 weeks of AT (p < 0.001). No significant change in SRT70 was observed in the control group. In the study group, the magnitude of SRT70 improvement was not correlated to the total number of AT hours. A large inter-patient variability was observed for speech-in-noise intelligibility measured once the AT program was completed and at re-test. The results suggest that serious game-based AT may improve speech-in-noise intelligibility in adult CI users. Potential sources of inter-patient variability are discussed. Serious gaming may be considered as a complementary training approach for improving CI outcomes in adults. [ABSTRACT FROM AUTHOR]

Ethical standards in audiology have been continuously improved and discussed, leading to the elaboration of specific regulatory guidelines for the profession. However, in the field of auditory rehabilitation, audiologists are still faced with circumstances that question their ethical principles, usually associated with the support of the hearing aids industry. The study explores the decision-making process and ethical concerns in auditory rehabilitation as they relate to the practice of audiology in Portugal. An online questionnaire constructed by the authors was used and sent to the email addresses of a list of audiologists, registered with the Portuguese Association of Audiologists. The questionnaire was answered by 93 audiologists with clinical experience in auditory rehabilitation for more than one year. The collected data demonstrated that audiometric results and clinical experience are the most important factors for decision-making in auditory rehabilitation practice. Moreover, incentives from the employers or manufacturers were identified as the main cause of ethical dilemmas. This study highlights the ethical concerns regarding the clinical practice of auditory rehabilitation in Portugal, revealing that the decision-making process is complex and, specifically in this field, the current practice may not be adequate for effective compliance with professional ethical standards. [ABSTRACT FROM AUTHOR]

A fully implantable active middle ear device has been proposed and indicated for the rehabilitation of bilateral moderate or moderate-to-severe sensorineural hearing loss, assuming it would overcome the disadvantages of a conventional hearing aid. The indications have further been extended to severe or severe-to-profound forms of hearing loss in the case of an expected limited or null efficacy of hearing aids. While the literature has highlighted several positive aspects of the device, including a better quality of life related to its invisibility, the improvement of auditory and perceptual functions has not been controlled for throughout a long period of follow-up. The present study aimed to verify the behavior of the auditory threshold, especially the bone conduction (BC) component, in the implanted ear in a group of implantees affected by initial bilateral symmetric hearing loss of different severity grades. The BC threshold was assessed preoperatively at activation and at the last follow-up (ranging from 4 to 12 years) in the implanted ear, and preoperatively and at the last follow-up in the contralateral ear, to monitor eventual deteriorated values in both ears over time. The pure tone average (PTA; 250–4,000 Hz), speech reception threshold (SRT) and the maximum word recognition score as a percentage (% WRS) and in dB HL were measured in the implanted ear to verify the efficacy of the device after the first fitting at device activation. A significant worsening of the BC threshold with respect to the baseline threshold was noticed during further follow-up. When comparing the implanted ear with the contralateral ear, a significant worsening of the bone PTA was assessed in the former with respect to the contralateral ear. Despite the worsened hearing found in the implanted ears, the beneficial gains in PTA and speech audiometry observed at the first activation remained constant at the follow-up, thus showing an extension of the efficacy of this device in aiding those with up to the most severe forms of sensorineural hearing loss.

A fully implantable active middle ear device has been proposed and indicated for the rehabilitation of bilateral moderate or moderate-to-severe sensorineural hearing loss, assuming it would overcome the disadvantages of a conventional hearing aid. The indications have further been extended to severe or severe-to-profound forms of hearing loss in the case of an expected limited or null efficacy of hearing aids. While the literature has highlighted several positive aspects of the device, including a better quality of life related to its invisibility, the improvement of auditory and perceptual functions has not been controlled for throughout a long period of follow-up. The present study aimed to verify the behavior of the auditory threshold, especially the bone conduction (BC) component, in the implanted ear in a group of implantees affected by initial bilateral symmetric hearing loss of different severity grades. The BC threshold was assessed preoperatively at activation and at the last follow-up (ranging from 4 to 12 years) in the implanted ear, and preoperatively and at the last follow-up in the contralateral ear, to monitor eventual deteriorated values in both ears over time. The pure tone average (PTA; 250–4,000 Hz), speech reception threshold (SRT) and the maximum word recognition score as a percentage (% WRS) and in dB HL were measured in the implanted ear to verify the efficacy of the device after the first fitting at device activation. A significant worsening of the BC threshold with respect to the baseline threshold was noticed during further follow-up. When comparing the implanted ear with the contralateral ear, a significant worsening of the bone PTA was assessed in the former with respect to the contralateral ear. Despite the worsened hearing found in the implanted ears, the beneficial gains in PTA and speech audiometry observed at the first activation remained constant at the follow-up, thus showing an extension of the efficacy of this device in aiding those with up to the most severe forms of sensorineural hearing loss. [ABSTRACT FROM AUTHOR]

Background: There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant.Methods: This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e. placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study.Results: The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients.Discussion: We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients.Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12619000609156 . Registered on April 23 2019. [ABSTRACT FROM AUTHOR]

Perception of emotion plays a major role in social interaction. Studies have shown that hearing loss and aging degrade emotional recognition. The main aim of the present study was to evaluate the benefit of first-time hearing aids (HA) for emotional prosody perception in presbycusis patients. Secondary objectives comprised comparison with normal-hearing subjects, and assessment of the impact of demographic and audiologic factors. To assess HA impact, 29 subjects with presbycusis were included. They were tested without HA and 1 month after starting to use HA. A test with emotional hearing stimuli (Montreal Affective Voice test: MAV) was performed at various intensities (50, 65 and 80 dB SPL). Patients' experience was evaluated on the Profile of Emotional Competence questionnaire, before and after HA fitting. Results were compared with those of 29 normal-hearing subjects. Auditory rehabilitation did not significantly improve MAV results (P > 0.005), or subjective questionnaire results (P > 0.005). Scores remained lower than those of normal-hearing subjects (P < 0.001). MAV results, before and after HA, showed significant correlation with pure-tone average (r = −0.88, P < 0.001) and age (r = 0.44, P = 0.018). The older the presbycusis patient and the more severe the hearing loss, the greater the difficulty in recognising emotional prosody. Despite hearing rehabilitation, presbycusis patients' results remained poorer than in normal-hearing subjects. [ABSTRACT FROM AUTHOR]

Background and Aim: Elderly people usually show poor performance in dichotic listening tasks. In this condition, the left ear being often the weaker one shows a performance below the normal limits. Studies have shown the effectiveness of dichotic listening training in auditory and language processing for adults and children with neurological disorders. This study aimed to develop a home-version of dichotic training and investigate its effectiveness in elderly adults. Methods: Participants in this single-subject interventional study (AB design) were four elderly subjects (two males and two females) aged 65-75 years. The main inclusion criteria were dichotic listening deficit demonstrated by the dichotic digit test (DDT), no neurological or cognitive disorders, and normal hearing threshold. Dichotic listening training was performed with an informal home-version of dichotic interaural intensity difference (DIID) training program for seven weeks. DDT was performed seven consecutive weeks before (phase A) and after the intervention (phase B) at the end of each week. Results: Data were analyzed by single-subject study statistics. Findings demonstrated an improvement in DDT scores for the left ear and decrease in right ear advantage scores in all the elderly adults after DIID training program. It seems that this training program could remediate poor performance in dichotic listening tasks in elderly people. Conclusion: The advantage of this method is that it can be easily done at home and is costeffective. However, further studies are needed to approve the neuroplasticity and structural changes in the brain after the DIID training program in this population. [ABSTRACT FROM AUTHOR]

Objectives: Hearing improves significantly with bimodal provision, i.e., a cochlear implant (CI) at one ear and a hearing aid (HA) at the other, but performance shows a high degree of variability resulting in substantial uncertainty about the performance that can be expected by the individual CI user. The objective of this study was to explore how auditory event-related potentials (AERPs) of bimodal listeners in response to spoken words approximate the electrophysiological response of normal hearing (NH) listeners.Study Design: Explorative prospective analysis during the first 6 months of bimodal listening using a within-subject repeated measures design.Setting: Academic tertiary care center.Participants: Twenty-seven adult participants with bilateral sensorineural hearing loss who received a HiRes 90K CI and continued use of a HA at the non-implanted ear. Age-matched NH listeners served as controls.Intervention: Cochlear implantation.Main Outcome Measures: Obligatory auditory evoked potentials N1 and P2, and the event-related N2 potential in response to monosyllabic words and their reversed sound traces before, as well as 3 and 6 months post-implantation. The task required word/non-word classification. Stimuli were presented within speech-modulated noise. Loudness of word/non-word signals was adjusted individually to achieve the same intelligibility across groups and assessments.Results: Intelligibility improved significantly with bimodal hearing, and the N1–P2 response approximated the morphology seen in NH with enhanced and earlier responses to the words compared to their reversals. For bimodal listeners, a prominent negative deflection was present between 370 and 570 ms post stimulus onset (N2), irrespective of stimulus type. This was absent for NH controls; hence, this response did not approximate the NH response during the study interval. N2 source localization evidenced extended activation of general cognitive areas in frontal and prefrontal brain areas in the CI group.Conclusions: Prolonged and spatially extended processing in bimodal CI users suggests employment of additional auditory–cognitive mechanisms during speech processing. This does not reduce within 6 months of bimodal experience and may be a correlate of the enhanced listening effort described by CI listeners.

Cochlear implants (CI) improve hearing for the severely hearing impaired. With an extension of implantation candidacy, today many CI listeners use a hearing aid on their contralateral ear, referred to as bimodal listening. It is uncertain, however, whether the brains of bimodal listeners can combine the electrical and acoustical sound information and how much CI experience is needed to achieve an improved performance with bimodal listening. Patients with bilateral sensorineural hearing loss undergoing implant surgery were tested in their ability to understand speech in quiet and in noise, before and again 3 and 6 months after provision of a CI. Results of these bimodal listeners were compared to age-matched, normal hearing controls (NH). The benefit of adding a contralateral hearing aid was calculated in terms of head shadow, binaural summation, binaural squelch, and spatial release from masking from the results of a sentence recognition test. Beyond that, bimodal benefit was estimated from the difference in amplitudes and latencies of the N1, P2, and N2 potentials of the brains' auditory evoked response (AEP) toward speech. Data of fifteen participants contributed to the results. CI provision resulted in significant improvement of speech recognition with the CI ear, and in taking advantage of the head shadow effect for understanding speech in noise. Some amount of binaural processing was suggested by a positive binaural summation effect 6 month post-implantation that correlated significantly with symmetry of pure tone thresholds. Moreover, a significant negative correlation existed between binaural summation and latency of the P2 potential. With CI experience, morphology of the N1 and P2 potentials in the AEP response approximated that of NH, whereas, N2 remained different. Significant AEP differences between monaural and binaural processing were shown for NH and for bimodal listeners 6 month post-implantation. Although the grand-averaged difference in N1 amplitude between monaural and binaural listening was similar for NH and the bimodal group, source localization showed group-dependent differences in auditory and speech-relevant cortex, suggesting different processing in the bimodal listeners. [ABSTRACT FROM AUTHOR]

Background and Aim: Auditory rehabilitation is an essential step after hearing aid fitting for children with hearing loss. The aim of this study was to evaluate the auditory rehabilitation results based on auditory verbal therapy approach in children with severe to profound sensory-neural hearing loss. Auditory verbal therapy is a popular approach for rehabilitation children with hearing loss. Methods: This is a retrospective study that evaluates the results of auditory rehabilitation of 19 children with severe to profound hearing loss. Most children were about three years old at the beginning of the rehabilitation process. They were received bilateral hearing aid and auditory rehabilitation based on auditory verbal therapy (AVT) approach. Each case progress was measured by Newsha developmental scale. Results: All of the children showed progress during the AVT program (p < 0.05). The Newsha developmental scale showed that hearing and receptive language categories had more progress. The progress was similar between male and female participants and there was no difference in all of categories (p > 0.05). Conclusion: The AVT approach is beneficial for rehabilitation of older children with bilateral severe to profound sensory-neural hearing loss. The progress was observed in all categories of Newsha developmental scale. [ABSTRACT FROM AUTHOR]

Objectives: Hearing improves significantly with bimodal provision, i.e., a cochlear implant (CI) at one ear and a hearing aid (HA) at the other, but performance shows a high degree of variability resulting in substantial uncertainty about the performance that can be expected by the individual CI user. The objective of this study was to explore how auditory event-related potentials (AERPs) of bimodal listeners in response to spoken words approximate the electrophysiological response of normal hearing (NH) listeners. Study Design: Explorative prospective analysis during the first 6 months of bimodal listening using a within-subject repeated measures design. Setting: Academic tertiary care center. Participants: Twenty-seven adult participants with bilateral sensorineural hearing loss who received a HiRes 90K CI and continued use of a HA at the non-implanted ear. Age-matched NH listeners served as controls. Intervention: Cochlear implantation. Main Outcome Measures: Obligatory auditory evoked potentials N1 and P2, and the event-related N2 potential in response to monosyllabic words and their reversed sound traces before, as well as 3 and 6 months post-implantation. The task required word/non-word classification. Stimuli were presented within speech-modulated noise. Loudness of word/non-word signals was adjusted individually to achieve the same intelligibility across groups and assessments. Results: Intelligibility improved significantly with bimodal hearing, and the N1–P2 response approximated the morphology seen in NH with enhanced and earlier responses to the words compared to their reversals. For bimodal listeners, a prominent negative deflection was present between 370 and 570 ms post stimulus onset (N2), irrespective of stimulus type. This was absent for NH controls; hence, this response did not approximate the NH response during the study interval. N2 source localization evidenced extended activation of general cognitive areas in frontal and prefrontal brain areas in the CI group. Conclusions: Prolonged and spatially extended processing in bimodal CI users suggests employment of additional auditory–cognitive mechanisms during speech processing. This does not reduce within 6 months of bimodal experience and may be a correlate of the enhanced listening effort described by CI listeners. [ABSTRACT FROM AUTHOR]

Abstract Introduction Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was well-structured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices.

Intralabyrinthine schwannomas (ILS) are rare tumors that frequently cause sensorineural hearing loss. The development and increased use of magnetic resonance imaging in recent years have facilitated the diagnosis of these tumors that present with otherwise nondiscriminant symptoms such as tinnitus, vertigo, and hearing loss. The following is a review of the presentation, pathophysiology, imaging, and treatment with a focused discussion on auditory rehabilitation options of ILS. [ABSTRACT FROM AUTHOR]

It is known that the development of auditory skills in children with hearing loss, who use assistive listening devices, requires training and practice. The aims of this research were a) to describe an auditory training software developed in order to help children with cochlear implants and/or hearing aids improve their auditory skills and monitor their performance, and b) to demonstrate the usability of the auditory training tool. The software is mobile-based and uses VR (Virtual Reality) and Immersive technology. In order to use it, the user must wear a VR headset. This technology was adopted because these devices are considered to be innovative, and are especially popular among children. The software was tested on fourteen hearing-impaired children. Eleven of these children use a cochlear implant and three use hearing aids. The results of this research show that the children with hearing loss were able to play the game successfully. This positive outcome supports the use of VR and Immersive technology as Auditory Training Tools. [ABSTRACT FROM AUTHOR]

Objectives The impact of hearing loss and of auditory rehabilitation (hearing aid, cochlear implant) on quality of life is a crucial issue. Commonly used questionnaires to assess quality of life in these patients (Nijmegen, APHAB, GBI) are time-consuming, difficult for patients to fill out, and show poor sensitivity to small improvements or deterioration. The objective of the present study was to validate a dedicated quality of life scale for hearing-impaired adults with or without auditory rehabilitation. Material and methods ERSA (Évaluation du Retentissement de la Surdité chez l’Adulte: Evaluation of the Impact of Hearing Loss in Adults) is a self-administered questionnaire. It is divided into 4 domains, each comprising 5 questions graded from 1 to 10. The questions are simple, and formulated so patients will answer according to how they feel at the actual time of the session. Test-retest reliability was measured in 38 patients. Internal coherence and validity against the APHAB questionnaire as gold standard and in relation to hearing performance were measured in 122 patients at auditory assessment. Sensitivity to change in hearing was measured in 36 cochlear implant patients, before and 6 or 12 months after implantation. Results Test-retest reliability was very satisfactory (ρ = 0.88). Internal coherence was good for all questions. External validity, comparing ERSA to APHAB scores in the same non-implanted hearing-impaired patients, was good (ρ = 0.52). Additionally, ERSA scores correlated with hearing performance in adverse conditions (monosyllabic words: ρ = 0.22; sentences in noise: ρ = 0.19). In patients tested before and after cochlear implantation, improvement in hearing performance in silence and in noise correlated with an improvement in ERSA score (ρ = 0.37 to 0.59, depending on the test), but not to GBI score. Conclusion The ERSA questionnaire is easy and quick to use, reliable, and sensitive to change in hearing performance after cochlear implantation. [ABSTRACT FROM AUTHOR]

Introduction Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was wellstructured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices. [ABSTRACT FROM AUTHOR]

There is substantial variability in speech recognition ability across patients with cochlear implants (CIs), auditory brainstem implants (ABIs), and auditory midbrain implants (AMIs). To better understand how this variability is related to central processing differences, the current electroencephalography (EEG) study compared hearing abilities and auditory-cortex activation in patients with electrical stimulation at different sites of the auditory pathway. Three different groups of patients with auditory implants (Hannover Medical School; ABI: n = 6, CI: n = 6; AMI: n = 2) performed a speeded response task and a speech recognition test with auditory, visual, and audio-visual stimuli. Behavioral performance and cortical processing of auditory and audio-visual stimuli were compared between groups. ABI and AMI patients showed prolonged response times on auditory and audio-visual stimuli compared with NH listeners and CI patients. This was confirmed by prolonged N1 latencies and reduced N1 amplitudes in ABI and AMI patients. However, patients with central auditory implants showed a remarkable gain in performance when visual and auditory input was combined, in both speech and non-speech conditions, which was reflected by a strong visual modulation of auditory-cortex activation in these individuals. In sum, the results suggest that the behavioral improvement for audio-visual conditions in central auditory implant patients is based on enhanced audio-visual interactions in the auditory cortex. Their findings may provide important implications for the optimization of electrical stimulation and rehabilitation strategies in patients with central auditory prostheses. Hum Brain Mapp 38:2206-2225, 2017. © 2017 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]