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Purpose To examine the influence of demographic, audiologic, and hearing-aid (HA)-related variables on HA outcomes. Methods In total, 235 adults with hearing loss (HL) who used HAs for at least 3 months were included in the study, and completed audiologic tests and the Chinese version of the International Outcome Inventory for Hearing Aids (IOI-HA). Spearman correlation analysis and Wilcoxon test were conducted to identify factors related to IOI-HA overall and subscales scores. Stepwise multiple linear regression analysis was subsequently performed to determine the influence of factors on HA outcomes. Results Age, daily use time, HA price, pure tone average (PTA) threshold, word recognition score (WRS), fitting (bilateral or unilateral), and HA style were associated with IOI-HA overall and subscales scores. However, only WRS, daily HA use time, HA price, and age entered the final regression model and were factors determining HA outcomes. Conclusions HA outcome is a multi-dimensional construct. In this study, WRS had the greatest influence on HA outcomes and seemed to be a primary predictor. Thus, HA owners with a higher WRS before HA fitting may indicate better satisfaction. Daily use time, HA price, and patient age also made significant contributions to HA outcomes and should be considered in clinical practice to facilitate auditory rehabilitation.

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.govNCT04691830. Registered under the name “Adaptation of a Rehabilitation Program for Prosody and its Application on Egyptian Hearing Impaired Children”. Retrospectively registered

The purpose of this study was to investigate the relationship between graduated students with major in speech therapy and auditory rehabilitation and their working experience in the clinical field by using a qualitative research method. After conducting in-depth interviews with seven graduates who majored in speech therapy and hearing rehabilitation, content analysis was performed. As a result of open coding the interview data, 2 dimensions, 8 core categories, 13 subcategories, and 69 concepts were derived. The 2 dimensions were divided into personal and social dimensions. Employment considerations, overall work, the relationship between majors and work, and the skills needed to perform work were discussed. This study explained the current status of work and job satisfaction of graduates from the department of speech therapy and audiology rehabilitation, a considerable relation between majors and jobs, and future development directions.

Wer kennt sie nicht aus seinem Praxisalltag? Patienten, die schlecht horen und bezweifeln, dass ihnen wirklich geholfen werden kann. Dabei konnen heute alle Horstorungen dank der Weiterentwicklung der medizinischen und apparativen Moglichkeiten behandelt werden. In diesem Beitrag werden die wichtigsten Methoden der auditiven Rehabilitation vorgestellt.

Background Standards for auditory rehabilitation are currently lacking for adults who receive cochlear implants. Speech recognition outcomes are highly variable, and many adults with cochlear implants present with suboptimal performance. Functional real-life communication abilities are not routinely measured clinically and are not strongly linked to performance on traditional measures of speech recognition. In fact, even individuals with relatively good speech recognition outcomes often present with persistent communication difficulties. In contrast to pediatric cochlear implant users, speech-language pathologists are not routinely involved in the rehabilitation of adults who receive cochlear implants. Purpose The purpose of this article is to describe the value of including a speech-language pathologist in a comprehensive approach to auditory rehabilitation for adults with cochlear implants. Method The theoretical and clinical foundations of incorporating a speech-language pathologist into an adult auditory rehabilitation program are discussed. A description of the skills and potential roles of the speech-language pathologist for providing adult cochlear implant rehabilitation services is presented, along with potential barriers to implementation. Conclusion Person-centered management of postlingually deafened adults with cochlear implants can be augmented by a more complete approach utilizing the skill set of a speech-language pathologist. Supplemental Material https://doi.org/10.23641/asha.14669652

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.

To present a case study of a hearing rehabilitation service in the city of São Paulo. Reorganization of the patient's auditory rehabilitation process, proposed by the Technical Area of The Person of Disability of the Municipal Health Department, introducing the Shared Multiprofessional Reception, with a view to the one established in the Care Line and the Singular Therapeutic Project. Previously, patients in the region scheduled for diagnosis complied with the following Protocol: 1. ENT physician - Service Entry; 2. Audiological Evaluation; 3. Otorhinolaryngologist - diagnosis and conduct; 4. Audiologist - pre-mold and pre-selection of the device; 5. Audiologist - Test and definition of the Device and 6. Delivery/Dispensing of the Device. This process of entry to the concession of hearing aids took up to 12 months. The reorganization took place in 4 Phases: 1. (April/2015) - scheduling for the realization of Steps 1, 2 and 3 of the Protocol; 2. (October/2015) - inclusion of Stage 4 (1 otorhinolaryngologist and 2 audiologists); 3. (January/2017) - inclusion according to otorhinolaryngologist and only way of entering the service; 4. (April/2017) - inclusion of Social Work. With this operating model, it was observed a reduction in the number of returns, optimization of schedules, improvement of access to the service and reduction of time between the first consultation and the granting of hearing devices from twelve (12) to four (4) months. The patient's process for auditory rehabilitation within the Service was all restructured and described, constituting a model to be replicated. The reorganization was a successful experience. Presentar un estudio de caso de un servicio de rehabilitación auditiva en la ciudad de São Paulo. Reorganización del proceso de rehabilitación auditiva del paciente, propuesta por el Área Técnica de La Persona de Discapacidad del Departamento Municipal de Salud, introduciendo la Recepción Multiprofesional Compartida, con vistas a la establecida en la Línea asistencial y el Proyecto Terapéutico Singular. Previamente, los pacientes de la región programados para el diagnóstico cumplían con el siguiente Protocolo: 1. Médico otorrinolaringólogo - Ingreso al Servicio; 2. Evaluación Audiológica; 3. Otorrinolaringólogo - diagnóstico y conducta; 4. Audiólogo - pre-moldeo y preselección del dispositivo; 5. Audiólogo - Prueba y definición del Dispositivo y 6. Entrega/Dispensación del Dispositivo. Este proceso de ingreso a la concesión de audífonos tomó hasta 12 meses La reorganización se llevó a cabo en 4 Fases: 1. (Abril/2015) - programación para la realización de los Pasos 1, 2 y 3 del Protocolo; 2. (octubre/2015) - inclusión de la etapa 4 (1 otorrinolaringólogo y 2 l audiólogos); 3. (enero/2017) - inclusión según otorrinolaringólogo y única forma de entrar en el servicio; 4. (abril/2017) - inclusión de Trabajo Social. Con este modelo operativo, se observó una reducción en el número de retornos, optimización de horarios, mejora del acceso al servicio y reducción del tiempo entre la primera consulta y el otorgamiento de audífonos de doce (12) a cuatro (4) meses. El proceso del paciente para la rehabilitación auditiva dentro del Servicio fue reestructurado y descrito, constituyendo un modelo a replicar. La reorganización fue una experiencia exitosa. Apresentar estudo de caso de um serviço de reabilitação auditiva do Município de São Paulo. Reorganização do processo de reabilitação auditiva do paciente, proposta pela Área Técnica da Pessoa com Deficiência da Secretaria Municipal de Saúde, introduzindo o Acolhimento Multiprofissional Compartilhado, com vistas ao estabelecido na Linha de Cuidados e do Projeto Terapêutico Singular. Anteriormente, os pacientes da região agendados para diagnóstico, cumpriam o seguinte Protocolo: 1. Médico otorrinolaringologista – Entrada no Serviço; 2. Avaliação Audiológica; 3. Otorrinolaringologista - diagnóstico e conduta; 4. Fonoaudiólogo – pré-molde e pré-seleção do aparelho; 5. Fonoaudiólogo – Teste e definição do Aparelho e 6. Entrega/Dispensação do Aparelho, sendo que tal processo da entrada à concessão dos dispositivos auditivos de amplificação levava até 12 meses. A reorganização aconteceu em 4 Fases: 1. (abril/2015) - agendamento para realização das Etapas 1, 2 e 3 do Protocolo; 2. (outubro/2015) - inclusão da Etapa 4 (1 otorrinolaringologista e 2 fonoaudiólogos); 3. (janeiro/2017) - inclusão segundo otorrinolaringologista e única forma de entrada no serviço; 4. (abril/2017) - inclusão do Serviço Social. Com esse modelo de funcionamento, foi constatada a redução no número de retornos, otimização das agendas, melhoria do acesso ao serviço e redução do tempo entre a primeira consulta e a concessão dos dispositivos auditivos de doze (12) para quatro (4) meses. O processo do paciente para a reabilitação auditiva dentro do Serviço foi todo reestruturado e descrito, constituindo-se como um modelo a ser replicado. A reorganização constituiu-se como uma experiência de sucesso.

Introduction: Patients with a mixed hearing loss present special challenge. The amplification demands of mixed hearing loss can drive digital hearing aids to their limits and introduce dist...

Objetivo: Determinar, por meio de uma revisão sistemática, os resultados auditivos da reabilitação por meio de prótese auditiva em indivíduos com Perda Auditiva Unilateral (PAUn), no que se refere às habilidades de reconhecimento de fala na presença de ruído competitivo, localização da fonte sonora, satisfação e tempo de uso da prótese auditiva. Método: O levantamento bibliográfico foi realizado nas bases de dados Cochrane, Lilacs, Medline, Pubmed e Scielo, buscando triar estudos publicados entre 1997 e 2017, com os seguintes descritores em português: perda auditiva unilateral e auxiliares de audição; e em inglês: unilateral hearing loss e hearing aid. Os critérios de seleção dos estudos foram, amostra de indivíduos com PAUn, com idade mínima de 18 anos, que tivessem sido submetidos a avaliações de resultados voltados para a investigação do reconhecimento de fala na presença de ruído e/ou localização da fonte sonora e/ou satisfação e/ou tempo de uso da prótese auditiva, pré e pós-adaptação de prótese auditiva. Resultados: Após o levantamento bibliográfico, seis artigos foram analisados. Conclusão: Observou-se escassez de estudos voltados para a investigação da reabilitação por meio de prótese auditiva em indivíduos com PAUn. Apesar da maioria dos estudos demonstrarem benefício e satisfação com a adaptação de prótese auditiva, parte desta população não faz uso da mesma. A adaptação de prótese auditiva nesta população deve ser incentivada, levando em consideração a avaliação da demanda comunicativa de cada indivíduo, sua restrição de participação, principais queixas auditivas deste indivíduo pré e pós-adaptação e do ajuste de programação da prótese auditiva.

Cochlear implant surgery is a successful procedure for auditory rehabilitation of patients with severe to profound hearing loss. However, cochlear implantation may lead to damage to the inner ear, which decreases residual hearing and alters vestibular function. It is now of increasing interest to preserve residual hearing during this surgery because this is related to better speech, music perception, and hearing in complex listening environments. Thus, different efforts have been tried to reduce cochlear implantation-related injury, including periprocedural glucocorticoids because of their anti-inflammatory properties. Different routes of administration have been tried to deliver glucocorticoids. However, several drawbacks still remain, including their systemic side effects, unknown pharmacokinetic profiles, and complex delivery methods. In the present review, we discuss the role of periprocedural glucocorticoid therapy to decrease cochlear implantation-related injury, thus preserving inner ear function after surgery. Moreover, we highlight the pharmacokinetic evidence and clinical outcomes which would sustain further interventions.

The bone conductive implants (BCI) are nowadays a reliable alternative for rehabilitation of specific forms of hearing loss, i.e. conductive, mixed or single sided deafness (SSD). Aims/Objective: To analyse the various factors in play when considering an auditory rehabilitation with a bone-conductive device (BCI).The clinical charts of subjects who underwent BCI application at the same Implanting Center from 2005 to 2018 were retrieved analysing also the reason for eventual explantation and the alternative option (transition) for hearing rehabilitation.Nine BAHA Compact, 4 BAHA Intenso, 21 BAHA Divino, 3 BAHA BP100, 4 Ponto, 2 Sophono, 5 Bonebridge, 5 BAHA5 Attract; 11 BAHA5 Connect were used in 12 unilateral COM; 16 bilateral COM; 3 unilateral cholesteatoma; 6 bilateral cholesteatoma; 2 unilateral otosclerosis; 5 bilateral otosclerosis; 9 congenital malformations; 6 major otoneurosurgical procedures; 5 sudden deafness. Explantation was necessary for five subjects.Middle ear pathology and sequels from surgery represent the most common reason for BCI implantation, both in unilateral and in bilateral cases. Transition from one implantable device to another one can be predictable, mostly when explantation is necessary.The role of BCI for rehabilitation in middle ear pathology may be extremely important.

"Hearing loss in the pediatric population can have significant social and developmental implications. Early auditory rehabilitation by at least 6 months of age is imperative. Although traditional hearing aids are often a first-line treatment option, there is a wide array of implantable auditory devices available. This article describes the indications for such devices as they pertain to the pediatric population, including osseointegrated bone-conduction devices, middle ear implants, cochlear implants, and auditory brainstem implants."

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. Keywords: Auditory rehabilitation; dichotic training; dichotic listening; elderly; singlesubject study

To identify the psychosocial assessments utilized with individuals with conductive and/or mixed hearing loss as part of a broader effort by the Auditory Rehabilitation Outcomes Network (AURONET) group to develop a core set of patient-centred outcome measures. A review of articles published between 2006 and 2016 was completed. Included studies had more than three adult participants, were available in English, and reported a psychosocial outcome from any treatment of mixed and/or conductive hearing loss. Sixty-six articles from seven databases. Sixty-six articles met our inclusion/exclusion criteria. Within this set, 15 unique psychosocial or patient-reported outcome measures (PROs) were identified, with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Glasgow Benefit Inventory (GBI) being the most frequently dispensed. Five of the fifteen were only administered in one study. In-house questionnaires (IHQs) were reported in 19 articles. Only 66 (22%) of the 300 articles with outcomes contained a PRO. Some of the mostly frequently employed PROs (e.g., APHAB) were judged to include only social items and no psychological items. Lack of PRO standardization and the use of IHQs make psychosocial comparisons across treatments in this population difficult for patients, clinicians and stakeholders.

Introduction: In the present work, a review is conducted on hearing loss, its origin, the consequences of the lack of a timely treatment, the possibilities and benefits provided by the access to a cochlear implant and the corresponding auditory rehabilitation. Materials and Methods: The methods used in the present work were Ling Test, Vowel Recognition, Consonant Recognition, Two-syllable Word Test, and Open-set Sentence Recognition. Results: By means of a descriptive study of a population that received a cochlear implant and after one year of use, we can observe high rates of auditory discrimination in all the variables presented and their levels of requirement and complexity, showing a close relationship between an appropriate and timely approach and a successful auditory rehabilitation. Conclusion: In all of the cases in this sample, the cochlear implant led to an improved quality of life for both the patients and their family members, allowing children to develop the language and improve their performance in school activities, and adults to appropriately reintegrate into society.

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.

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. Keywords: Auditory rehabilitation; auditory verbal therapy approach; hearing-impaired

We report a case in which we quantified the maturation of the central auditory pathway in children with hearing loss and associated disabilities; the audiological intervention was performed using the BAHA softband. The hearing aid was applied according to the international clinical protocols. The presented case reveals the importance of using the P1 CAEP biomarker in clinical practice along with a neuropsychological evaluation to assess the maturation of the central auditory pathways and to objectively quantify the results of auditory rehabilitation in children with hearing loss and associated disabilities.

BACKGROUND AND OBJECTIVES The present study probed into the relative and combined contribution of auditory and visual modalities in the speech perception of individuals with auditory neuropathy spectrum disorders (ANSD). Specifically, the identification scores of consonantvowel (CV) syllables, visual enhancement (VE), and auditory enhancement in different signal to noise ratios (SNRs) were compared with that of the control group. Subjects and. METHODS The study used a repeated measure standard group comparison research design. Two groups of individuals in the age range of 16 to 35 years participated in the study. The clinical group included 35 participants diagnosed as ANSD, while the control group had 35 age and gender matched individuals with typical auditory abilities. The participants were assessed for CV syllable identification in auditory only (A), visual only (V), and auditory-visual (AV) modalities. The syllables were presented in quiet and at 0 dB SNR. RESULTS The speech identification score was maximum in AV condition followed by A-condition and least in V condition. This was true in both the groups. The individuals with ANSD were able to make better use of visual cues than the control group, as evident in the VE score. CONCLUSIONS The dynamics of speech perception in the AV mode is different between ANSD and control. There is definite benefit of auditory as well as visual cues to individuals with ANSD, suggesting the need to facilitate both the modalities as part of the audiological rehabilitation. Future studies can focus on independently facilitating the two modalities and testing the benefits in the AV mode of speech perception in individuals with ANSD.

An auditory brainstem implant (ABI) is an option for auditory rehabilitation in patients with totally ossified cochleae who cannot receive a conventional cochlear implant.To evaluate the outcomes in audiometry and speech perception tests after the implantation of an ABI via the extended retrolabyrinthine approach in patients with postmeningitis hearing loss.Ten patients, including children and adults, with postmeningitis hearing loss and bilateral totally ossified cochleae received an ABI in a tertiary center from 2009 to 2015. The extended retrolabyrinthine approach was performed in all the patients by the same surgeons. A statistical analysis compared pure tonal averages and speech perception tests before and at least 12 months after the ABI activation.Eight patients (80%) showed improvements in tonal audiometry and the word and vowel perception tests after an average follow-up of 3.3 years. Two patients recognized up to 40% of the closed-set sentences without lip-reading. Two patients had no auditory response.The ABI improved hearing performance in audiometry and speech perception tests in cases of postmeningitis hearing loss. The extended retrolabyrinthine approach is a safe surgical option for patients with postmeningitis hearing loss and bilateral totally ossified cochleae.

Objective: Explore the acceptability of a socialisation, health education and falls prevention programme (Walk and Talk for Your Life: WTL) as an adjunct to group auditory rehabilitation (GAR) and how it might be adapted for older adults with hearing loss (HL). Design: Content theme analysis (CTA) of guided interviews explored the experience of HL, the acceptability of a WTL programme and suggestions on how to adapt the WTL programme to better suit the needs of older adults with HL. Study sample: Twenty-eight (20 women, 8 men) adults (>55 years of age) with HL were interviewed. Seventeen had participated in past WTL programmes and eleven were sampled from the community. Results: Interviewees reported difficulty socialising and a tendency to withdraw from social interactions. Addition of GAR to a WTL programme was found to be highly acceptable. Interviewees suggested that to best suit their needs, sessions should take place in a location with optimal acoustics; include small groups integrating hearing-impaired and hearing-intact participants; include appropriate speaking ground rules; and include an option for partner involvement. Conclusions: The adapted WTL programme provides a holistic and unique approach to the treatment of HL that has the potential to positively impact the hearing-impaired elderly.

Objectives (1) To assess the 11-item Inner Effectiveness of Auditory Rehabilitation (Inner EAR) instrument with item response theory (IRT). (2) To determine whether the underlying latent ability could also be accurately represented by a subset of the items for use in high-volume clinical scenarios. (3) To determine whether the Inner EAR instrument correlates with pure tone thresholds and word recognition scores. Design IRT evaluation of prospective cohort data. Setting Tertiary care academic ambulatory otolaryngology clinic. Subjects and Methods Modern psychometric methods, including factor analysis and IRT, were used to assess unidimensionality and item properties. Regression methods were used to assess prediction of word recognition and pure tone audiometry scores. Results The Inner EAR scale is unidimensional, and items varied in their location and information. Information parameter estimates ranged from 1.63 to 4.52, with higher values indicating more useful items. The IRT model provided a basis for identifying 2 sets of items with relatively lower information parameters. Item information functions demonstrated which items added insubstantial value over and above other items and were removed in stages, creating a 8- and 3-item Inner EAR scale for more efficient assessment. The 8-item version accurately reflected the underlying construct. All versions correlated moderately with word recognition scores and pure tone averages. Conclusion The 11-, 8-, and 3-item versions of the Inner EAR scale have strong psychometric properties, and there is correlational validity evidence for the observed scores. Modern psychometric methods can help streamline care delivery by maximizing relevant information per item administered.

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.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.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.The ERSA questionnaire is easy and quick to use, reliable, and sensitive to change in hearing performance after cochlear implantation.

The spatial auditory change complex (ACC) is a cortical response elicited by a change in place of stimulation. There is growing evidence that it provides a useful objective measure of electrode discrimination in cochlear implant (CI) users. To date, the spatial ACC has only been measured in relatively experienced CI users with one type of device. Early assessment of electrode discrimination could allow auditory stimulation to be optimized during a potentially sensitive period of auditory rehabilitation. In this study we used a direct stimulation paradigm to measure the spatial ACC in both pre- and post-lingually deafened adults. We show that it is feasible to measure the spatial ACC in different CI devices and as early as 1 week after CI switch-on. The spatial ACC has a strong relationship with performance on a behavioural discrimination task and in some cases provides information over and above behavioural testing. We suggest that it may be useful to measure the spatial ACC to guide auditory rehabilitation and improve hearing performance in CI users.

This “Cochrane Corner” will be a recurring feature in the journal that highlights systematic reviews relevant to audiology, with invited commentary to aid clinical decision making. This first instalment features the Cochrane review “Interventions to Improve Hearing Aid Use in Adult Auditory Rehabilitation,” published in 2016. In their review, Barker et al identified 37 randomised controlled trials (RCTs) and concluded that there is low-quality evidence using self-management support and complex interventions (support plus delivery system design) in adult auditory rehabilitation. The review highlights the need for well-conducted studies in this area.

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.

Background: Severe-to-profound sensorineural hearing loss (spSNHL) is mostly relying on the use of a cochlear implant (CI).Aims: The present study reports on the auditory outcome from a group of su...

Mestrado em Gestão e Avaliação de Tecnologias em Saúde Submitted by Maria da Luz Antunes (mluz.antunes@estesl.ipl.pt) on 2021-03-15T19:28:05Z No. of bitstreams: 1 Dispositivos médicos de reabilitação auditiva_caracterização do mercado em Portugal.pdf: 1034048 bytes, checksum: 66b56ac1ddf6a870bb6ead3c79b8e240 (MD5) Made available in DSpace on 2021-03-15T19:28:05Z (GMT). No. of bitstreams: 1 Dispositivos médicos de reabilitação auditiva_caracterização do mercado em Portugal.pdf: 1034048 bytes, checksum: 66b56ac1ddf6a870bb6ead3c79b8e240 (MD5) Previous issue date: 2020 N/A

Cochlear implants (CIs) provide a tool for hearing reconstruction. How to effectively and reasonably evaluate the auditory rehabilitation level of CI children has always been a difficult problem, especially for those with prelingual deafness. Many studies have used electroencephalograph (EEG) technology for CI users, which have shown that EEG is suitable for clinical postoperative evaluation. This study aims to explore changes of latencies and amplitudes of P1 wave in CI children under auditory stimulation. A pure tone at 1000 Hz was used as the stimuli to induce cortical auditory evoked potentials (CAEP). The characteristics of P1 wave were compared between normal hearing children and CI children over different implantation period. Results show that CI children started to have improved auditory perception after implantation, moreover, their P1 wave amplitude becomes similar to that of normal hearing children after six months. One year after implantation, the characteristics of P1 wave of CI children become similar to those of normal hearing children. Therefore, it seems that P1 could be used as an objective auditory rehabilitation assessing indicator for CI children.

Purpose: The purpose of present study was 1) to investigate the current practice and participation of parents in auditory rehabilitation for children with cochlear implants (CIs), and 2) to suggest for developing the contents of smart device applications as a tool of their auditory rehabilitation. Methods: A questionnaire was developed to examine the current practice, participation, and needs of smart device applications in auditory rehabilitation and background information. Seventy-seven parents of children with CIs participated in the survey. Results: The parents most frequently used the smartphones for their daily lives and improvement of their children’s auditory performance, followed by tablet PCs and smart TVs. They also allowed children with CIs to use smart devices in order to respond to their children’s requests, to let the children learn something, and to soothe children’s temper tantrums. The parents highly desired smart device applications of auditory habilitation for children with CIs, and there was not a significant difference between groups (infants, preschoolers, schoolers) and types of contents (auditory skills, auditory-language skills, parental education). Conclusion: The results demonstrated that parents were very interested in the possibility of using smart device applications as a tool for improving auditory performance of their children. The current results suggest that parents have needs to receive the auditory rehabilitation services via the smart device applications of their children with CIs.

Purpose of review Sudden sensorineural hearing loss (SNHL) is an otologic emergency and should be managed quickly and effectively. This review focuses on the management of sudden SNHL, primarily idiopathic sudden SNHL as it is the most common cause. Recent findings Management options include observation, oral steroids, intratympanic steroids, or combined oral/intratympanic steroids. One-third to two-thirds of patients will achieve spontaneous recovery, most likely within the first 2 weeks. Despite the lack of randomized controlled trials on steroid therapy efficacy, all patients should be offered steroid treatment given low risk and possible significant benefits. All patients should undergo MRI with gadolinium to rule out retrocochlear disorder. Bilateral sudden hearing loss should alert the clinician to possible systemic disease. Summary Sudden hearing loss is an otologic emergency. Appropriate counseling of patients is necessary to allow physician and patient to make a joint, educated decision. It is paramount to rule out retrocochlear disorder and to follow patients closely for improvement or need for future auditory rehabilitation.

Purpose: Auditory disability due to impaired auditory processing (AP) despite normal pure-tone thresholds is common after stroke, and it leads to isolation, reduced quality of life and physical decline. There are currently no proven remedial interventions for AP deficits in stroke patients. This is the first study to investigate the benefits of personal frequency-modulated (FM) systems in stroke patients with disordered AP. Methods: Fifty stroke patients had baseline audiological assessments, AP tests and completed the (modified) Amsterdam Inventory for Auditory Disability and Hearing Handicap Inventory for Elderly questionnaires. Nine out of these 50 patients were diagnosed with disordered AP based on severe deficits in understanding speech in background noise but with normal pure-tone thresholds. These nine patients underwent spatial speech-in-noise testing in a sound-attenuating chamber (the “crescent of sound”) with and without FM systems. Results: The signal-to-noise ratio (SNR) for 50% correct speech recognition performance was measured with speech presented from 0° azimuth and competing babble from ±90° azimuth. Spatial release from masking (SRM) was defined as the difference between SNRs measured with co-located speech and babble and SNRs measured with spatially separated speech and babble. The SRM significantly improved when babble was spatially separated from target speech, while the patients had the FM systems in their ears compared to without the FM systems. Conclusions: Personal FM systems may substantially improve speech-in-noise deficits in stroke patients who are not eligible for conventional hearing aids. FMs are feasible in stroke patients and show promise to address impaired AP after stroke.Implications for RehabilitationThis is the first study to investigate the benefits of personal frequency-modulated (FM) systems in stroke patients with disordered AP.All cases significantly improved speech perception in noise with the FM systems, when noise was spatially separated from the speech signal by 90° compared with unaided listening.Personal FM systems are feasible in stroke patients, and may be of benefit in just under 20% of this population, who are not eligible for conventional hearing aids. This is the first study to investigate the benefits of personal frequency-modulated (FM) systems in stroke patients with disordered AP. All cases significantly improved speech perception in noise with the FM systems, when noise was spatially separated from the speech signal by 90° compared with unaided listening. Personal FM systems are feasible in stroke patients, and may be of benefit in just under 20% of this population, who are not eligible for conventional hearing aids.

Objectives: To introduce a psychological model of behaviour; the COM-B model and describe how this has been used in combination with the behaviour change wheel (BCW) in developing an intervention which aims to promote regular, long-term use of hearing aids by adults with acquired hearing loss. Design: Qualitative structured interview study using the COM-B model to identify the determinants of behavioural planning on the part of audiologists; a potentially important factor in encouraging long-term hearing-aid use. Study sample: Ten audiologists drawn from a random sample of five English audiology departments. Results: The analysis suggests that behavioural planning might be more likely to occur if audiologists’ psychological capability, physical and social opportunity, and reflective and automatic motivation were addressed. This analysis forms the basis of an intervention design, using the BCW, to encourage behavioural planning by audiologists and subsequent hearing-aid use by people with hearing loss. Conclusions: The COM-B model and BCW can be applied successfully in the context of audiology to analyse the behaviour of both people with hearing loss and professionals working with them, supplying information that is being used in intervention design. The effectiveness of the intervention will be tested in a clinical trial.

RESUMO Para melhoria do desenvolvimento das habilidades auditivas e da linguagem na criança com deficiência auditiva, além da terapia fonoaudiológica, a família deve ser o agente modificador para uma resposta terapêutica satisfatória. Estudos que analisem a efetividade de programas de intervenção fonoaudiológica por meio de videofeedback são importantes, dados os efeitos positivos desta ferramenta para a modificação de comportamentos com famílias de crianças com deficiência. Acredita-se, assim, que a intervenção por meio do videofeedback contribuirá para a melhoria das interações comunicativas entre as famílias e crianças atendidas pelos serviços de reabilitação auditiva. Os objetivos deste estudo foram investigar a interação entre as famílias e as crianças com deficiência auditiva, analisar a autoestima e a satisfação das famílias antes e após um programa de intervenção por meio do videofeedback. Ensaio clínico não randomizado, com estudo de casos em dois grupos, experimental (n=5) e controle (n=5). A intervenção contou com o apoio do vídeo de interação e de instrumentos adaptados. Protocolos pré e pós-intervenção foram aplicados. Observou-se melhora nas interações entre as famílias e crianças com deficiência auditiva nos casos do grupo experimental, bem como melhora na autoestima dos participantes deste grupo. O grupo experimental demonstrou satisfação com a intervenção realizada. Concluiu-se que o programa de intervenção fonoaudiológica baseado no videofeedback teve efeitos positivos na interação entre a família e criança e na autoestima dos pais. Estudos com controles metodológicos rigorosos deverão ser realizados para a comprovação de sua eficácia para famílias de crianças com deficiência auditiva.

The deteriorating ability to communicate has a negative impact on quality of life in the aging population. Cochlear implantation is increasingly used to treat hearing impairment and to restore the ability to communicate. Here, in a sample of 79 adults (70 years and older), we explored the effect of cochlear implantation on the health-related quality of life via the Nijmegen Cochlear Implant Questionnaire, auditory performance for speech recognition comparing scores on the Freiburg Monosyllabic Test and Oldenburg Inventory and tinnitus-related distress using the German version of the Tinnitus Questionnaire. We observed that the health-related quality of life and auditory performance increased significantly after cochlear implantation for the study cohort. After implantation, tinnitus-related distress declined significantly for the group. Our results support the concept of cochlear implantation treatment positively influencing the quality of life, restoring the auditory performance in older adults and reducing stress related to tinnitus. Importantly, positive effects were seen as early as 6 months after cochlear implantation, corroborating the rationale for cochlear implantation in adults 70 years and older.

Hearing aids (HAs) are an effective strategy for auditory rehabilitation in patients with peripheral hearing deficits. Yet, the neurophysiological mechanisms behind HA use are still unclear. Thus far, most studies have focused on changes in the auditory system, although it is expected that hearing deficits affect a number of cognitive systems, notably speech. In the present study, we used audiometric evaluations in 14 patients with bilateral hearing loss before and after one year of continuous HA use and functional magnetic resonance imaging (fMRI) and cortical thickness analysis in 12 and 10 of them compared with a normal hearing control group. Prior to HA fitting, fMRI activity was found reduced in the auditory and language systems and increased in visual and frontal areas, expanding to multimodal integration cortices, such as the superior temporal gyrus, intraparietal sulcus, and insula. One year after rehabilitation with HA, significant audiometric improvement was observed, especially in free-field Speech Reception Threshold (SRT) test and functional gain, a measure of HA efficiency. HA use increased fMRI activity in the auditory and language cortices and multimodal integration areas. Individual fMRI signal changes from all these areas were positively correlated with individual SRT changes. Before rehabilitation, cortical thickness was increased in parts of the prefrontal cortex, precuneus, fusiform gyrus, and middle temporal gyrus. It was reduced in the insula, supramarginal gyrus, medial temporal gyrus, occipital cortex, posterior cingulate cortex, and claustrum. After HA use, increased cortical thickness was observed in multimodal integration regions, particularly the very caudal end of the superior temporal sulcus, the angular gyrus, and the inferior parietal gyrus/superior temporal gyrus/insula. Our data provide the first evidence that one year of HA use is related to functional and anatomical brain changes, notably in auditory and language systems, extending to multimodal cortices.

Adult sensorineural hearing loss is a result of genetic and environmental influences. Despite limited options for auditory rehabilitation and treatment, sensorineural hearing loss may warrant further investigation given its connection with serious disease processes. This article explores various etiologies of sensorineural hearing loss and focusses on the investigations and management strategies for each.

Many research groups have developed various questionnaires for hearing-impaired listeners since 1990 while proving their reliability and validity. Currently, audiologists are able to use some of them at the beginning and/or end of consultation with their hearing-impaired patients and thus to estimate specific problems related to hearing loss, difficult listening situations, degree of disability including psychosocial and emotional aspects, and benefit from hearing aids based on numerical values of questionnaires. However, although these questionnaires have their own purposes and interpretation, the audiologists sometimes underuse or overuse them due to unfamiliarity. This paper reviews the most popular 11 questionnaires with the purpose, contents, scoring, and interpretation for the hearing-impaired adults and elderly. It also includes their pros and cons. Finally, it discusses which questionnaire should be considerable and need to be developed in clinical setting of Korea. This paper suggests that the questionnaires should extend effective auditory rehabilitation program.

It is well known that hearing abilities decline with age, and one of the most commonly reported hearing difficulties reported in older adults is a reduced ability to understand speech in noisy environments. Older musicians have an enhanced ability to understand speech in noise, and this has been associated with enhanced brain responses related to both speech processing and the deployment of attention, however the causal impact of music lessons in older adults is poorly understood. A sample of older adults was randomly assigned to learn to play piano (Mus), to learn to play a visuo-spatially demanding video-game (Vid), or to serve as a no-contact control (Nocon).After 6 months, the Mus group improved their ability to understand a word presented in loud background noise. This improvement was related to an earlier N100, enhanced P250 (P2/P3) and a reduced N600 (N400). These findings support the idea that music lessons provide a causal benefit to hearing abilities, and that this benefit is due to both enhanced encoding of speech stimuli, and enhanced deployment of attentional mechanisms towards the speech stimuli. Importantly, these findings suggest that music training could be used as a foundation to develop auditory rehabilitation programs for older adults.