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Children with unilateral or mild bilateral hearing loss are increasingly identified in early childhood. Relatively little is known about how hearing loss affects their developmental trajectory or whether it contributes to parenting stress for these parents. This study aimed to examine child behavior and parenting stress in parents of children with unilateral/mild bilateral hearing loss compared to children with typical hearing. This prospective study involved 54 children with unilateral/mild bilateral hearing loss identified at a median age of 4.5 months (IQR 2.6, 6.5) and 42 children with typical hearing. At age 48 months, child behavior and parenting stress were measured. Auditory and language results were also analyzed in relation to child behavior and parenting stress. Parents of these children did not report significantly more parenting stress or behavior problems than parents of children with typical hearing. However, both parenting stress and child behavior were related to functional hearing in noise. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the quality of global guidelines or consensus statements for newborn and childhood hearing screening, as well as to compare various guidelines between other countries and China.Methods: A PROSPERO registered systematic review (number CRD42021242198) was conducted. Multiple electronic databases and government websites including PubMed, EMBASE, Web of Science, CENTRAL, Cochrane Library, and BMJ Best Practice were searched from inception until May 2021. The latest national and international guidelines, consensus statements, technical specifications, and recommendations regarding newborn or childhood hearing screening that were published in Chinese or English medical journals or elsewhere with the full version available online. The following information was extracted independently by two reviewers for comparative analysis: titles, authors, publication year, country, the source organization, and main key recommendations using systems for assigning the level of evidence and strength of recommendations. The quality of the guidelines was assessed by three independent reviewers using the Appraisal of Guidelines for Research and Evaluation, 2nd edition. Intraclass correlation coefficients (ICCs) were calculated to assess among-reviewer agreement.Results: We assessed 15 newborn and 6 childhood hearing screening guidelines, respectively. Most newborn guidelines recommend the 1-3-6 guidelines and pre-discharge screening; however, the specific screening times differ. 93.33% of newborn hearing guidelines recommend "primary screening-re-screening-diagnosis-intervention" for well-babies while 73.33% of the guidelines recommend "initial screening-diagnosis-intervention" for newborns in neonatal intensive care unit (NICU); 33.33% of the newborn hearing guidelines recommended initial screening coverage of > 95% while 46.66% did not mention it. Further, 26.66% of the newborn hearing guidelines recommended a referral rate to diagnosis within 4% while 60% did not mention it. Regarding childhood hearing screening guidelines, the screening populations differed across guidelines (age range: 0-9 years); most guidelines recommend pediatric hearing screening for all preschoolers. Only 50% of the guidelines specify screening and re-screening techniques, including pure-tone hearing screening, OAE, tympanometry, and others. The "Clarity of Presentation" domain achieved the highest mean score, and the lowest was "Editorial Independence" both in newborn and childhood guidelines. Overall score of newborn hearing screening guidelines ranged from 3 (2018 Europe) to 7 (2019 America), with an average score of 5.33. Average score of childhood hearing screening guidelines was 4.78, with the score ranging from 4 (2017 England, 2012 Europe, 2016 WHO) to 6.67 (2011 America). ICC analysis revealed excellent agreement across 21 guidelines (> 0.75).Conclusions: These findings indicated newborn hearing screening guidelines had superior quality over childhood ones. Comparative analysis suggested that recommendations of the Chinese newborn and pediatric hearing screening protocols are consistent with the mainstream international opinion. Moreover, this analysis demonstrated that "Editorial Independence" and "Stakeholder Involvement" have the greatest opportunities for improvement. These results may help to advance the quality of hearing screening guidelines in clinical practice and guide evidence-based updates. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study were to (a) demonstrate the feasibility of administering categorical loudness scaling (CLS) tests in a remote setting, (b) assess the reliability of remote compared with laboratory CLS results, and (c) provide preliminary evidence of the validity of remote CLS testing. Method: CLS data from 21 adult participants collected in a home setting were compared to CLS data collected in a laboratory setting from previous studies. Five participants took part in studies in both settings. Precalibrated equipment was delivered to participants who performed headphone output level checks and measured ambient noise levels. After a practice run, CLS measurements were collected for two runs at 1 and 4 kHz. Results: Mean headphone output levels were within 1.5 dB of the target calibration level. Mean ambient noise levels were below the target level. Within-run variability was similar between the two settings, but across-run bias was smaller for data collected in the laboratory setting compared with the remote setting. Systematic differences in CLS functions were not observed for the five individuals who participated in both settings. Conclusions: This study demonstrated that precise stimulus levels can be delivered and background noise levels can be controlled in a home environment. Across-run bias for remote CLS was larger than for in-laboratory CLS, indicating that further work is needed to improve the reliability of CLS data collected in remote settings. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine the effects of symmetrical and asymmetrical directional microphone settings on speech recognition, localisation and microphone preference in listening conditions with on- and off-axis talkers. A within-subjects repeated-measure evaluation of three hearing aid microphone settings (bilateral omnidirectional, bilateral directional, asymmetrical directional) was completed in a moderately reverberant laboratory. An exploratory analysis of the potential relationship between microphone preference and unaided measures was also completed. Twenty adult listeners with mild to moderately severe bilateral hearing loss participated. The directional and asymmetric microphone settings resulted in equivalent benefits for sentence recognition in noise, word recall, and localisation speed regardless of the speech loudspeaker location (on- or off-axis). However, localisation accuracy was significantly worse with the asymmetric fitting than the directional setting when speech was presented from the rear hemisphere. Listeners who always preferred directional microphones had significantly poorer unaided speech recognition than those who preferred the omnidirectional setting for one or more listening condition. Benefits from directional and asymmetric processing were small in the current study, but generally similar to each other. Unaided speech recognition in noise performance may have utility as a clinical predictor of preference for directional processing. [ABSTRACT FROM AUTHOR]

Sampling distortion product otoacoustic emissions (DPOAEs) at multiple f2/f1 ratios and f2 frequency values produces a DPOAE "map." This study examined the efficacy of DPOAE mapping compared with pure tone audiometry and standard DPOAEs for detecting noise effects in subjects exposed to loud sound. A map significance score was developed as a single measure of map change. Significance scores were evaluated before and after exposure to: loud music (LM), controlled noise (CN), and firing range noise (FR) in three separate sets of subjects. Scores were compared to audiometry and standard DPOAE results in the LM study. The LM and CN exposure studies involved 22, and 20 healthy young subjects respectively with normal hearing. Eight Marines were studied before and after FR exposure. After LM exposure, audiometry showed significant changes at 1, 2, 4, and 6 kHz. Standard DPOAE measures were also significantly different at several frequencies. Map significance scores detected changes more effectively and showed the distribution of DPOAE alterations. Map significance scores detected changes after noise exposure more reliably than audiometry and standard DPOAEs. Additionally, maps showed a diffuse response to sound exposure perhaps explaining why individual DP-grams appear less sensitive. [ABSTRACT FROM AUTHOR]

Objectives: To examine the longitudinal association between subclinical hearing loss (SCHL) and neurocognitive performance. Design: Longitudinal analyses were conducted among 2,110 subjects who underwent audiometric testing in a US multi-centered epidemiologic cohort study. The primary exposure was better ear hearing (pure tone average). SCHL was defined as hearing ≤ 25 dB. The primary outcome was neurocognitive performance, measured by Digit Symbol Substitution Test (DSST), Modified Mini Mental State Examination (3MS), and CLOX1. Linear mixed models were performed to assess the longitudinal association between hearing and cognitive performance, adjusting for covariates. Models were fit among all individuals and among individuals with SCHL only. Results: Among 2,110 participants, mean (SD) age was 73.5 (2.9) years; 52.3% were women. Mean (SD) better ear pure tone average was 30.0 (13.1) dB. Mean follow-up was 9.1 years (range 3–16). Among all participants, worse hearing was associated with significantly steeper cognitive decline measured by the DSST [0.054-point/year steeper decrease per 10 dB worse hearing, 95% confidence interval (CI): 0.026–0.082] and 3MS (0.044-point/year steeper decrease per 10 dB worse hearing, CI: 0.026–0.062), but not CLOX1. Among those with SCHL, worse hearing was associated with significantly steeper cognitive performance decline as measured by DSST (0.121-point/year steeper decrease per 10 dB worse hearing, CI: 0.013–0.228), but not CLOX1 or 3MS. Conclusion: Among those with SCHL, worse hearing was associated with steeper cognitive performance declines over time as measured by DSST. The relationship between hearing loss and cognition may begin at earlier levels of hearing loss than previously recognized. [ABSTRACT FROM AUTHOR]

West syndrome (WS), or infantile spasms, is a rare type of epilepsy that usually appears in the 1st year of life. It is characterized by a specific type of seizure called a spasm, which involves sudden, brief jerks of the arms, legs, or trunk. These spasms can occur in clusters and may be accompanied by other seizure types. The cause of WS is not clear, but it is thought to be related to abnormal brain development or damage. In some cases, it may be associated with genetic mutations or other underlying conditions such as Down syndrome or tuberous sclerosis. Early diagnosis and treatment are important, as untreated WS can lead to developmental delays and intellectual disability. In this article, a 2-year and 7-month-old male was diagnosed with WS; his hearing evaluation was carried out to assess the impact of syndrome on audition. Audiological test battery was used which reveals hearing sensitivity within normal limits in both the ears. Speech and language skills development were delayed. [ABSTRACT FROM AUTHOR]

Background  The COVID-19 pandemic has made wearing face masks a common habit in public places. Several reports have underlined the increased difficulties encountered by deaf people in speech comprehension, resulting in a higher risk of social isolation and psychological distress. Purpose  To address the detrimental effect of different types of face masks on speech perception, according to the listener hearing level and background noise. Research Design  Quasi-experimental cross-sectional study. Study Sample  Thirty patients were assessed: 16 with normal hearing [NH], and 14 hearing-impaired [HI] with moderate hearing loss. Data Collection and Analysis  A speech perception test (TAUV) was administered by an operator trained to speak at 65 dB, without a face mask, with a surgical mask, and with a KN95/FFP2 face mask, in a quiet and in a noisy environment (cocktail party noise, 55 dB). The Hearing Handicap Index for Adults (HHI-A) was administered twice, asking subjects to complete it for the period before and after the pandemic outburst. A 2-way repeated-measure analysis of variance was performed. Results  The NH group showed a significant difference between the no-mask and the KN95/FFP2-mask condition in noise (p  = 0.01). The HI group showed significant differences for surgical or KN95/FFP2 mask compared with no-mask, and for KN95/FFP2 compared with surgical mask, in quiet and in noise (p  < 0.001). An increase in HHI-A scores was recorded for the HI patients (p  < 0.001). Conclusion  Face masks have a detrimental effect on speech perception especially for HI patients, potentially worsening their hearing-related quality of life. [ABSTRACT FROM AUTHOR]

The improvement in the quality of CT imaging in recent years has led to increasing use in the preoperative workup before primary stapedotomy. The aim of this study is to determine whether routine CT scanning is justified by analysing whether the detectability of otoclerotic foci in the CT imaging is associated with a different clinical picture or surgical outcome. Retrospective analysis of patient charts, CT data sets, preoperative and postoperative audiograms of 41 patients who underwent 47 primary stapedotomies. The preoperative and short-term postoperative audiometric thresholds were analysed at 0.5, 1, 2 and 4 kHz. In 36 of 47 ears (76.5%), fenestral otosclerosis was observed in the CT scans. Among those 36 'CT-positive' ears, five ears (13.8%) showed additional signs of retrofenestral (cochlear) otosclerosis. The preoperative audiogram results showed no significant differences in the air conduction threshold, bone conduction threshold or air-bone gap between the CT-positive and CT-negative groups. The overall average preoperative air-bone gap (26.4 dB ± 8.3 dB) improved to 12 dB (±7.6 dB) postoperatively, without a significant difference between the CT-positive and CT-negative groups. The detectability of otosclerotic foci on CT scans did not correlate with the preoperative audiogram or the ability to close the air-bone gap postoperatively. The CT scans did not reveal new information that influenced the decision to operate or which side to operate. The findings do not support routine preoperative CT scanning in suspected otosclerosis cases. CT imaging may complement audiological tests in atypical cases. Even in straightforward cases, preoperative CT scanning may be offered to patients in order to guide the preoperative counselling. However, the patients should be made aware of the associated radiation risks. [ABSTRACT FROM AUTHOR]

This study investigates three aspirated voiceless stop consonants and their unaspirated counterparts produced in Taiwan's Southern Min dialect by 10 laryngeal speakers (LA), 10 speakers with pneumatic artificial larynxes (PA), and 10 oesophageal speakers (ES). Listeners' perceptions of the accuracy of the three groups in producing these six stop consonants were also examined. Each of the voiceless stop consonants /p, pʰ, t, tʰ, k, kʰ/, followed by the vowel /a/, was represented by a Southern Min character and appeared three times on a list in random order. Each character had a consonant-vowel syllable structure, and all were read with Tone 1 (high and level). Voice onset time (VOT) was measured for each stop consonant. A separate group of 20 listeners was then asked to identify the consonants produced by the LA, PA, and ES speakers. The VOT values of aspirated voiceless stop consonants from PA and ES were shorter than those from LA. Although PA and ES had aspiration contrast in their VOT values, perceived accuracy was low for PA (/pʰ/: 16.3%; /tʰ/: 13.5%; /kʰ/: 22.8%) and ES (/pʰ/: 33.7%; /tʰ/: 25.9%; /kʰ/: 31.9%). The mean percentages of correctly identified /pʰ, tʰ, kʰ/ produced by PA were at chance level. In terms of VOT values, it is recommended that, when producing aspirated voiceless stop consonants, PA and ES elongate the duration between the release of the oral constriction and the onset of their vibratory sound source. Moreover, it is also recommended that further investigation into other phonetic properties that support stop contrast is needed. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 is known to be a neurotrophic virus. However, the effect of this virus on the hearing system is still uncertain. We aimed to investigate the possible effect of COVID-19 on hearing. Thirty healthcare workers who had COVID-19 after hearing evaluation with pure tone audiometry (PTA) for any reason in the last 1 year were included in the study. PTA and transient evoked otoacoustic emissions (TEOAE) tests were performed in 15 of 30 patients during the active infection period. For all 30 patients, otoscopic examination plus PTA and TEOAE tests were performed at the end of the first month after their treatment. When the PTA results of 30 patients (60 ears) before and after COVID-19 were compared, a significant decrease in hearing level was found only at 1000 Hz (p <.05). There were no significant differences at other frequencies. When the PTA and TEAOE test results of 15 patients (30 ears) that were performed during and after COVID-19 were compared, no significant differences were found. We conclude that COVID-19 may cause hearing loss. However, this result needs to be confirmed with comprehensive studies to be conducted in larger patient groups. [ABSTRACT FROM AUTHOR]

Aim: Vision impairment (VI) and hearing impairment (HI), alone or in combination (dual sensory impairment [DSI]), are common in older adults. We determined (i) the association of vision and hearing, and of VI only, HI only and DSI, with three psychosocial variables (social network, loneliness, depressive symptoms) and with quality of life (QoL), and (ii) whether the considered psychosocial variables mediate the association of VI only, HI only and DSI with QoL among older adults. Methods: Cross‐sectional survey data for 4077 older adults (≥60 years) from Singapore were analyzed. Those with self‐reported fair or poor vision and hearing were considered to have an impairment in that sense. Standard scales were used to assess the psychosocial variables and QoL. Regression and mediation models were used. Results: Those with fair and poor vs. good, vision and hearing generally had poorer psychosocial outcomes and lower QoL. VI only, HI only and DSI were all associated with lower social network, more depressive symptoms and lower QoL. VI only and DSI were associated with more loneliness. Social network, loneliness and depressive symptoms partially mediated the association of VI only, HI only and DSI with QoL, with depressive symptoms being the strongest mediator. Conclusions: VI and HI, particularly in combination, are associated with poorer psychosocial status and QoL among older adults. Older adults with VI or HI should be screened for depressive symptoms and social risks. Improving social network, loneliness and depressive symptoms among older adults with sensory impairments may enhance their QoL. Geriatr Gerontol Int 2022; 22: 56–62. [ABSTRACT FROM AUTHOR]

Objective: Congenital infections can cause newborn hearing loss. Although vertical transmission of coronavirus disease 2019 (COVID‐19) infection is theoretically possible, this has not been proven yet. To our knowledge, there is no previous report on whether COVID‐19 infection during pregnancy can cause congenital hearing loss. This paper aimed to find an answer to this question. Method: This retrospective, single‐center study was performed between April 2020 and May 2021 at a tertiary care referral center in Turkey. A total of 422 pregnant women who had coronavirus infection during pregnancy were followed and 203 of them gave birth in our institution. Results of hearing screening tests of 199 newborns were assessed retrospectively. Results: Of patients included in the study, 23 (11.6%) had the disease in the first trimester, 62 (31.2%) in the second trimester, and 114 (57.3%) in the third trimester. In the first hearing test performed on newborns, unilateral hearing loss was observed in 21 babies (10.5%). Hearing tests of these newborns were found to be normal in the second test performed 15 days later. Conclusion: Considering the incidence of congenital hearing loss, the absence of hearing loss in our newborn population does not confirm the argument that coronavirus infection does not cause congenital hearing loss. This issue should be evaluated with larger patient series. In addition, it should be kept in mind that hearing loss can occur at later ages as well. [ABSTRACT FROM AUTHOR]

Background and Aim: Spatial hearing is a prerequisite for the proper function of the listener in complex auditory environments. In the present study, a Persian version of the dynamic spatial-quick speech in noise (DS-QSIN) has been developed with respect to all possible factors affecting the test and to run five lists for normal hearing subjects and assessment of reliability. Methods: To construct five new lists according to the original quick speech in noise (QSIN) test, we used frequent, familiar, and difficult words to construct unpredictable sentences. After determining the content and face validity of the sentences, 30 selected sentences were played using a DS-QSIN software for 35 subjects aged 18-25 years. The reliability of the test was assessed after repeating the test after two weeks. Results: According to expert judges, these 30 sentences showed acceptable content and face validity with the changes. The average signal-to-noise ratio (SNR) loss of five lists was -5.2 dB. No significant difference was seen between men and women in all lists. The results indicate no difference in the average SNR loss between the five lists. Regarding the reliability assessment, the test-retest correlation coefficient was 0.5 to 0.7 (p<0.05). The intra-class correlation coefficient between test-retest was statistically significant (p>0.001) and confirmed that the lists have high reliability and repeatability. Conclusion: DS-QSIN test showed good validity and reliability and can be helpful in diagnosis and selecting the best method for rehabilitation of people with a spatial hearing disorder. [ABSTRACT FROM AUTHOR]

Background and Aim: Noise tolerance and performance in noisy environments are influential factors of hearing aid use in people with hearing loss. One of the causes of hearing loss is Meniere's disease (MD), which affects speech perception in noise. Acceptable noise level (ANL) is a test that measures the maximum tolerated background noise level (BNL) while listening to the running speech. Since the effect of MD on ANL needs further study, the present study aims to examine the ANL test results in people with unilateral MD, and compare the results between the two ears. Methods: This cross sectional study conducted on 33 individuals with unilateral MD (21 females and 12 males) aged 32-60 years who had the disease for at least one year, who participated in this study. Their most comfortable level (MCL), BNL, and ANL in both ears were then evaluated. Results: The mean MCL and BNL were significantly different between the two ears, where they were higher in the affected ear than in the contralateral ear. There was also a significant difference in the ANL results between the two ears. In the affected ear, a statistically significant relationship was reported between the ANL and the average hearing thresholds at frequencies of250, 500, and 1000 Hz. Conclusion: MD affects the ANL in the affected ear and causes a deterioration in its level and speech perception in noise. [ABSTRACT FROM AUTHOR]

Shared decision-making is a principle of health care delivery across the world. The first international standard decision aid for tinnitus care was developed in 2018. This decision aid is in use across the UK. It is free to use and access from the British Tinnitus Association website. Our objective was to compare routine care with the care that also included the decision aid as part of care for their patients. A multi-site service evaluation included pre–post comparison of decisional conflict in sequential new patients seeking help with tinnitus. Informal interviews with staff and service managers explored how practical and feasible the decision aid was in routine practice. We present data from four contrasting clinical services, including services in England and Wales, acute and community services and those operated by Hearing Therapists and Audiologists. Across these contrasting services, the inclusion of the decision aid was associated with a reduction in decisional conflict in patients. The decision aid was feasible to administer, acceptable to patients and clinicians without creating a burden in appointments. These evaluations suggest that the decision aid is feasible to administer and reduces patient decisional conflict. It appears to benefit clinical services in practice. [ABSTRACT FROM AUTHOR]

Purpose: It is well recognized that adding the visual to the acoustic speech signal improves recognition when the acoustic signal is degraded, but how that visual signal affects postrecognition processes is not so well understood. This study was designed to further elucidate the relationships among auditory and visual codes in working memory, a postrecognition process. Design: In a main experiment, 80 young adults with normal hearing were tested using an immediate serial recall paradigm. Three types of signals were presented (unprocessed speech, vocoded speech, and environmental sounds) in three conditions (audio-only, audio--video with dynamic visual signals, and audio--picture with static visual signals). Three dependent measures were analyzed: (a) magnitude of the recency effect, (b) overall recall accuracy, and (c) response times, to assess cognitive effort. In a follow-up experiment, 30 young adults with normal hearing were tested largely using the same procedures, but with a slight change in order of stimulus presentation. Results: The main experiment produced three major findings: (a) unprocessed speech evoked a recency effect of consistent magnitude across conditions; vocoded speech evoked a recency effect of similar magnitude to unprocessed speech only with dynamic visual (lipread) signals; environmental sounds never showed a recency effect. (b) Dynamic and static visual signals enhanced overall recall accuracy to a similar extent, and this enhancement was greater for vocoded speech and environmental sounds than for unprocessed speech. (c) All visual signals reduced cognitive load, except for dynamic visual signals with environmental sounds. The follow-up experiment revealed that dynamic visual (lipread) signals exerted their effect on the vocoded stimuli by enhancing phonological quality. Conclusions: Acoustic and visual signals can combine to enhance working memory operations, but the source of these effects differs for phonological and nonphonological signals. Nonetheless, visual information can support better postrecognition processes for patients with hearing loss. [ABSTRACT FROM AUTHOR]

Purpose: Auditory feedback is thought to contribute to the online control of speech production. Yet, the standard method of estimating auditory feedback control (i.e., reflexive responses to auditory--motor perturbations), although sound, requires specialized instrumentation, meticulous calibration, unnatural tasks, and specific acoustic environments. The purpose of this study was to explore more ecologically valid features of speech production to determine their relationships with auditory feedback mechanisms. Method: Two previously proposed measures of within-utterance variability (centering and baseline variability) were compared with reflexive response magnitudes in 30 adults with typical speech. These three measures were estimated for both the laryngeal and articulatory subsystems of speech. Results: Regardless of the speech subsystem, neither centering nor baseline variability was shown to be related to reflexive response magnitudes. Likewise, no relationships were found between centering and baseline variability. Conclusions: Despite previous suggestions that centering and baseline variability may be related to auditory feedback mechanisms, this study did not support these assertions. However, the detection of such relationships may have required a larger degree of variability in responses, relative to that found in those with typical speech. Future research on these relationships is warranted in populations with more heterogeneous responses, such as children or clinical populations. [ABSTRACT FROM AUTHOR]

The aim of the current study was to investigate whether task-evoked pupillary responses measured during encoding, individual working memory capacity and noise reduction in hearing aids were associated with the likelihood of subsequently recalling an item in an auditory free recall test combined with pupillometry. Participants with mild to moderately severe symmetrical sensorineural hearing loss (n = 21) were included. The Sentence-final Word Identification and Recall (SWIR) test was administered in a background noise composed of sixteen talkers with noise reduction in hearing aids activated and deactivated. The task-evoked peak pupil dilation (PPD) was measured. The Reading Span (RS) test was used as a measure of individual working memory capacity. Larger PPD at a single trial level was significantly associated with higher likelihood of subsequently recalling a word, presumably reflecting the intensity of attention devoted during encoding. There was no clear evidence of a significant relationship between working memory capacity and subsequent memory recall, which may be attributed to the SWIR test and RS test being administered in different modalities, as well as differences in task characteristics. Noise reduction did not have a significant effect on subsequent memory recall. This may be due to the background noise not having a detrimental effect on attentional processing at the favorable signal-to-noise ratio levels at which the test was conducted. [ABSTRACT FROM AUTHOR]

Sensitivity to interaural time differences (ITDs) in acoustic hearing involves comparison of interaurally frequency-matched inputs. Bilateral cochlear-implant arrays are, however, only approximately aligned in angular insertion depth and scalar location across the cochleae. Interaural place-of-stimulation mismatch therefore has the potential to impact binaural perception. ITD left-right discrimination thresholds were examined in 23 postlingually-deafened adult bilateral cochlear-implant listeners, using low-rate constant-amplitude pulse trains presented via direct stimulation to single electrodes in each ear. Angular insertion depth and scalar location measured from computed-tomography (CT) scans were used to quantify interaural mismatch, and their association with binaural performance was assessed. Number-matched electrodes displayed a median interaural insertion-depth mismatch of 18° and generally yielded best or near-best ITD discrimination thresholds. Two listeners whose discrimination thresholds did not show this pattern were confirmed via CT to have atypical array placement. Listeners with more number-matched electrode pairs located in the scala tympani displayed better thresholds than listeners with fewer such pairs. ITD tuning curves as a function of interaural electrode separation were broad; bandwidths at twice the threshold minimum averaged 10.5 electrodes (equivalent to 5.9 mm for a Cochlear-brand pre-curved array). Larger angular insertion-depth differences were associated with wider bandwidths. Wide ITD tuning curve bandwidths appear to be a product of both monopolar stimulation and angular insertion-depth mismatch. Cases of good ITD sensitivity with very wide bandwidths suggest that precise matching of insertion depth is not critical for discrimination thresholds. Further prioritizing scala tympani location at implantation should, however, benefit ITD sensitivity. [ABSTRACT FROM AUTHOR]

A tablet-based language-independent self-test involving the recognition of ecological sounds in background noise, the Sound Ear Check (SEC), was adapted to make it feasible for young children. Two experiments were conducted. The first experiment investigated the SEC's feasibility, as well as its sensitivity and specificity for detecting childhood hearing loss with a monaural adaptive test procedure. In the second experiment, the SEC sounds, noise, and test format were adapted based on the findings of the first experiment. The adaptations were combined with three test procedures, one similar to the one used in Experiment 1, one presenting the sounds dichotically in diotic noise, and one presenting all the sounds with a fixed signal-to-noise ratio and a stopping rule. Results in young children show high sensitivity and specificity to detect different grades of conductive and sensorineural hearing loss (70–90%). When using an adaptive, monaural procedure, the test duration was approximately 6 min, and 17% of the results obtained were unreliable. Adaptive staircase analyses showed that the unreliable results probably occur due to attention/motivation loss. The test duration could be reduced to 3-4 min with adapted test formats without decreasing the test-retest reliability. The unreliable test results could be reduced from 17% to as low as 5%. However, dichotic presentation requires longer training, reducing the dichotic test format's feasibility. [ABSTRACT FROM AUTHOR]

A multi-talker paradigm is introduced that uses different attentional processes to adjust speech-recognition scores with the goal of conducting measurements at high signal-to-noise ratios (SNR). The basic idea is to simulate a group conversation with three talkers. Talkers alternately speak sentences of the German matrix test OLSA. Each time a sentence begins with the name "Kerstin" (call sign), the participant is addressed and instructed to repeat the last words of all sentences from that talker, until another talker begins a sentence with "Kerstin". The alternation of the talkers is implemented with an adjustable overlap time that causes an overlap between the call sign "Kerstin" and the target words to be repeated. Thus, the two tasks of detecting "Kerstin" and repeating target words are to be done at the same time. The paradigm was tested with 22 young normal-hearing participants (YNH) for three overlap times (0.6 s, 0.8 s, 1.0 s). Results for these overlap times show significant differences, with median target word recognition scores of 88%, 82%, and 77%, respectively (including call-sign and dual-task effects). A comparison of the dual task with the corresponding single tasks suggests that the observed effects reflect an increased cognitive load. [ABSTRACT FROM AUTHOR]

This study was designed to examine age effects on various auditory perceptual skills using a large group of listeners (155 adults, 121 aged 60–88 years and 34 aged 18–30 years), while controlling for the factors of hearing loss and working memory (WM). All subjects completed 3 measures of WM, 7 psychoacoustic tasks (24 conditions) and a hearing assessment. Psychophysical measures were selected to tap phenomena thought to be mediated by higher-level auditory function and included modulation detection, modulation detection interference, informational masking (IM), masking level difference (MLD), anisochrony detection, harmonic mistuning, and stream segregation. Principal-components analysis (PCA) was applied to each psychoacoustic test. For 6 of the 7 tasks, a single component represented performance across the multiple stimulus conditions well, whereas the modulation-detection interference (MDI) task required two components to do so. The effect of age was analyzed using a general linear model applied to each psychoacoustic component. Once hearing loss and WM were accounted for as covariates in the analyses, estimated marginal mean thresholds were lower for older adults on tasks based on temporal processing. When evaluated separately, hearing loss led to poorer performance on roughly 1/2 the tasks and declines in WM accounted for poorer performance on 6 of the 8 psychoacoustic components. These results make clear the need to interpret age-group differences in performance on psychoacoustic tasks in light of cognitive declines commonly associated with aging, and point to hearing loss and cognitive declines as negatively influencing auditory perceptual skills. [ABSTRACT FROM AUTHOR]

A signal processing approach combining beamforming with mask-informed speech enhancement was assessed by measuring sentence recognition in listeners with mild-to-moderate hearing impairment in adverse listening conditions that simulated the output of behind-the-ear hearing aids in a noisy classroom. Two types of beamforming were compared: binaural, with the two microphones of each aid treated as a single array, and bilateral, where independent left and right beamformers were derived. Binaural beamforming produces a narrower beam, maximising improvement in signal-to-noise ratio (SNR), but eliminates the spatial diversity that is preserved in bilateral beamforming. Each beamformer type was optimised for the true target position and implemented with and without additional speech enhancement in which spectral features extracted from the beamformer output were passed to a deep neural network trained to identify time-frequency regions dominated by target speech. Additional conditions comprising binaural beamforming combined with speech enhancement implemented using Wiener filtering or modulation-domain Kalman filtering were tested in normally-hearing (NH) listeners. Both beamformer types gave substantial improvements relative to no processing, with significantly greater benefit for binaural beamforming. Performance with additional mask-informed enhancement was poorer than with beamforming alone, for both beamformer types and both listener groups. In NH listeners the addition of mask-informed enhancement produced significantly poorer performance than both other forms of enhancement, neither of which differed from the beamformer alone. In summary, the additional improvement in SNR provided by binaural beamforming appeared to outweigh loss of spatial information, while speech understanding was not further improved by the mask-informed enhancement method implemented here. [ABSTRACT FROM AUTHOR]

Background: Permanent bilateral hearing loss (PBHL) is a serious condition in newborns, with a prevalence of at least one per 1000 live births. However, there has been no recent systematic review and meta-analysis of the effectiveness of universal newborn hearing screening programs (UNHS).Methods: We registered our study protocol on PROSPERO CRD42020175451. Primary outcomes were any identification of PBHL (ie, PBHL diagnosed at any time), age of identification of PBHL, and neurodevelopment. Two reviewers searched standard databases to March 2022 and extracted data. We used fixed and random effects meta-analysis to pool data and graded the certainty of evidence using standard methods.Results: The search retrieved 2834 records. We identified five studies reporting on the effects of UNHS vs no UNHS in 1 023 610 newborns. The relative risk of being identified with PBHL before nine months in infants with UNHS compared to infants without UNHS was 3.28 (95% confidence interval (95% CI) = 1.84, 5.85, one study, 1 023 497 newborns, low certainty evidence). The mean difference in the age of identification of PBHL in infants with UNHS compared to infants without UNHS was 13.2 months earlier (95% CI = -26.3, -0.01, two studies, 197 newborns, very low certainty evidence). The relative risk of infants eventually being identified with PBHL in infants with UNHS compared to infants without UNHS was 1.01 (95% CI = 0.89, 1.14, three studies, 1 023 497 newborns, low certainty evidence). At the latest follow-up at 3-8 years, the standardised mean difference (SMD) in receptive language development between infants with UNHS compared to infants without UNHS was 0.60 z scores (95% CI = 0.07, 1.13, one study, 101 children, low certainty evidence) and the mean difference in developmental quotients was 7.72 (95% CI = -0.03, 15.47, three studies, 334 children, very low certainty evidence). The SMD in expressive language development was 0.39 z scores (95% CI = -0.20, 0.97, one study, 87 children, low certainty evidence) and the mean difference in developmental quotients was 10.10 scores (95% CI = 1.47, 18.73, 3 studies, 334 children, very low certainty evidence).Conclusions: UNHS programs result in earlier identification of PBHL and may improve neurodevelopment. UNHS should be implemented across high-, middle-, and low-income countries.Registration: PROSPERO (CRD42020175451). [ABSTRACT FROM AUTHOR]

Purpose: Traditionally, auditory spatial acuity is assessed using a sound-field localization test that involves the auditory stimuli emitted from array of loudspeakers in a sound-treated room. Although the use of loudspeakers mimics real life environments, its reliability has not been evaluated in children. Thus, the present study examined the test--retest reliability of sound-field localization test in school-aged normal-hearing children. Materials and Methods: Twenty-four typically-developing children in the age range of 7--12 years (Mage: 9.97 ± 0.88) participated in the study. Localization testing was carried out twice on all the participants using an array of 18 loudspeakers (spaced 20° apart) arranged in a circular form. A 500 ms broadband noise was randomly presented at each azimuth. The overall accuracy and quadrant-specific accuracy scores were compared between the two sessions. Results: The Wilcoxon sign rank test results showed no significant difference in overall (P = 0.58) and quadrantwise accuracy scores between the two sessions. The intra-class correlation (ICC) results also demonstrated a high test--retest reliability (0.91) for the overall localization accuracy score. The results also showed low withinsubject variability (5.78%) of overall scores with a minimal response bias of 7.56%. Conclusions: The present study's results show a high test--retest reliability of the sound-field localization test, suggestive of its efficacy in assessing spatial processing abilities in school-aged children. High reliability of the test favors its application in localization assessment in children with spatial hearing disorders. [ABSTRACT FROM AUTHOR]

The paper presents the development of a method for assessing auditory perception and the effectiveness of applying hearing aids for hard-of-hearing people during short-term (up to 7 days) and longer-term (up to 3 months) use. The method consists of a survey based on the APHAB questionnaire. Additional criteria such as the degree of hearing loss, technological level of hearing aids used, as well as the user experience are taken into consideration. A web-based application is developed, allowing answering the survey questions from any computer with Internet access. The results of the benefit obtained from the use of hearing aids in various acoustic environments, taking into account the time of their use, are presented and compared to the earlier outcomes. The research results show that in the first period of use of hearing aids, speech perception improves, especially in noisy environments. The perception of unpleasant sounds also increases, which may lead to deterioration of hearing aid acceptance by their users. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the functional results of the superior pedicled composite multi-fractured osteoperiosteal flap technique. This method is a novel technique for the reconstruction of the external auditory canal. The study also examined the effect of the superior pedicled composite multi-fractured osteoperiosteal flap technique on patients' disease-related quality of life. Method: A total of 37 patients who underwent the superior pedicled composite multi-fractured osteoperiosteal flap technique were enrolled in the study. Their functional hearing results and disease-related quality of life scores were evaluated. Results: A significant improvement was observed in the patients' hearing scores at the post-operative sixth month relative to the pre-operative period, and the patients' disease-related quality of life increased significantly. Conclusion: The superior pedicled composite multi-fractured osteoperiosteal flap method can be safely used, especially in patients undergoing retrograde mastoidectomy because of limited cholesteatoma. This method contributes to improving patients' hearing levels and disease-related quality of life. [ABSTRACT FROM AUTHOR]

Purpose: Misophonia is a condition in which individuals experience negative reactions, including anger and disgust, to specific sounds in their environment. Individuals with misophonia often report feelings of anxiety and a reduced quality of life. While there is no cure for misophonia, there are management protocols supported by case studies in the literature, including tinnitus retraining therapy (TRT) and Misophonia Management Protocol (MMP), along with coping strategies. The purpose of this case study is to contribute to the field of clinical research on patients with misophonia. Method: Case studies involving misophonia are limited, and further research in this area is needed to provide evidencebased treatment. This case details misophonia questionnaires and assessment, case formulation, and management of misophonia in an 11-year-old girl, using a variation of both the TRT and MMP, including ear-level sound generators and coping strategies. Conclusions: This case serves as a contribution to the evidence base for the use of sound therapy and coping strategies in the treatment and management of misophonia, as well as tools that are available in diagnosing misophonia. Clinical implications reveal sound therapy and coping strategies as a means to manage misophonia symptoms. Further research is needed for large-scale data to be available. [ABSTRACT FROM AUTHOR]

Acoustic immittance measurements are one of the measurement methods that evaluate middle ear functions in general, give objective results and are frequently used in audiological test batteries. The concept of immittance; It is a term that refers to admittance, impedance and their components. The difficulty shown by the eardrum and middle ear system against the acoustic energy coming from the external ear canal is called acoustic impedance, while the ease shown is called acoustic admittance. Immittancemetric tests; It includes tympanometric evaluation, acoustic reflex measurements and eustachian tube function tests. Tympanometric evaluation is an important application of the immitansmetric test battery. The tympanic membrane, middle ear muscles, middle ear ossicles and middle ear cavity within the middle ear system are evaluated as a whole. The test can be applied to all age groups and all individuals without any differences. The measurement is made through a probe inserted into the external ear canal. Measurement results can be shown with a graph called tympanogram, based on the changes in outer ear and middle ear pressures and the amount of sound reflected back. Different tympanogram results are obtained in different pathologies. Although tympanometric evaluation is very important in detecting middle ear pathologies, it should be evaluated as a whole with other audiological tests. [ABSTRACT FROM AUTHOR]

A 12-month follow-up study showed that middle ear pressure treatment with a transtympanic membrane massage (TMM) device had a similar effect to a Meniett device. The effects of pressure treatment with a TMM device were retrospectively compared to the effects of treatment with a Meniett device in patients with Meniere's disease (MD) and delayed endolymphatic hydrops (DEH) who were followed for a minimum of 24 months. Twenty-seven patients were treated with the TMM device and 14 patients were treated with a Meniett device. The insertion of a transtympanic ventilation tube was necessary for the Meniett device but not for the TMM device. In patients treated with the TMM and Meniett devices, the frequency of vertigo significantly improved at 19–24 months after treatment. The distribution of vertigo at 19–24 months after treatment did not differ between the patients treated with the two types of devices. Pressure treatment for 8 months or more was suitable to achieve remission. Middle ear pressure treatment for 8 months or more with a TMM or Meniett device was equally effective and provided minimally invasive treatment options for intractable MD and DEH. [ABSTRACT FROM AUTHOR]

Multiple studies have demonstrated binaural hearing deficits in the aging and those with hearing loss. Consequently, there is great interest in developing efficient clinical tests of binaural hearing acuity to improve diagnostic assessments and to assist clinicians when fitting binaural hearing aids and/or cochlear implants. Two cortical measures of interaural phase difference sensitivity, the acoustic change complex (ACC) and interaural phase modulation following response (IPM-FR), were compared on three metrics using five different stimulus interaural phase differences (IPDs; 0°, ±22.5°, ±45°, ±67.5° and ±90°). These metrics were scalp topography, time-to-detect, and input–output characteristics. Ten young, normal-hearing listeners. Scalp topography qualitatively differed between ACC and IPM-FR. The IPM-FR demonstrated better time-to-detect performance on smaller (±22.5° and ±45°) but not larger (67.5°, and ±90°) IPDs. Input–output characteristics of each response were similar. The IPM-FR may be a faster and more efficient tool for assessing neural sensitivity to subtle IPD changes. However, the ACC may be useful for research or clinical questions concerned with the topographic representation of binaural cues. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to characterize spatial hearing abilities of children with longstanding unilateral hearing loss (UHL). UHL was expected to negatively impact children's sound source localization and masked speech recognition, particularly when the target and masker were separated in space. Spatial release from masking (SRM) in the presence of a two-talker speech masker was expected to predict functional auditory performance as assessed by parent report. Method: Participants were 5- to 14-year-olds with sensorineural or mixed UHL, age-matched children with normal hearing (NH), and adults with NH. Sound source localization was assessed on the horizontal plane (-90° to 90°), with noise that was either all-pass, low-pass, high-pass, or an unpredictable mixture. Speech recognition thresholds were measured in the sound field for sentences presented in two-talker speech or speechshaped noise. Target speech was always presented from 0°; the masker was either colocated with the target or spatially separated at ±90°. Parents of children with UHL rated their children's functional auditory performance in everyday environments via questionnaire. Results: Sound source localization was poorer for children with UHL than those with NH. Children with UHL also derived less SRM than those with NH, with increased masking for some conditions. Effects of UHL were larger in the two-talker than the noise masker, and SRM in twotalker speech increased with age for both groups of children. Children with UHL whose parents reported greater functional difficulties achieved less SRM when either masker was on the side of the better-hearing ear. Conclusions: Children with UHL are clearly at a disadvantage compared with children with NH for both sound source localization and masked speech recognition with spatial separation. Parents' report of their children's real-world communication abilities suggests that spatial hearing plays an important role in outcomes for children with UHL. [ABSTRACT FROM AUTHOR]

Sensorineural hearing loss (SNHL) is typically a permanent and often progressive condition that is commonly attributed to sensory cell loss. All vertebrates except mammals can regenerate lost sensory cells. Thus, SNHL is currently only treated with hearing aids or cochlear implants. There has been extensive research to understand how regeneration occurs in nonmammals, how hair cells form during development, and what limits regeneration in maturing mammals. These studies motivated efforts to identify therapeutic interventions to regenerate hair cells as a treatment for hearing loss, with a focus on targeting supporting cells to form new sensory hair cells. The approaches include gene therapy and small molecule delivery to the inner ear. At the time of this publication, early-stage clinical trials have been conducted to test targets that have shown evidence of regenerating sensory hair cells in preclinical models. As these potential treatments move closer to a clinical reality, it will be important to understand which therapeutic option is most appropriate for a given population. It is also important to consider which audiological tests should be administered to identify hearing improvement while considering the pharmacokinetics and mechanism of a given approach. Some impacts on audiological practice could include implementing less common audiological measures as standard procedure. As devices are not capable of repairing the damaged underlying biology, hair-cell regeneration treatments could allow patients to benefit more from their devices, move from a cochlear implant candidate to a hearing aid candidate, or move a subject to not needing an assistive device. Here, we describe the background, current state, and future implications of hair-cell regeneration research. [ABSTRACT FROM AUTHOR]

In complex listening environments, children can benefit from auditory spatial cues to understand speech in noise. When a spatial separation is introduced between the target and masker and/or listening with two ears versus one ear, children can gain intelligibility benefits with access to one or more auditory cues for unmasking: monaural head shadow, binaural redundancy, and interaural differences. This study systematically quantified the contribution of individual auditory cues in providing binaural speech intelligibility benefits for children with normal hearing between 6 and 15 years old. In virtual auditory space, target speech was presented from + 90° azimuth (i.e., listener's right), and two-talker babble maskers were either co-located (+ 90° azimuth) or separated by 180° (–90° azimuth, listener's left). Testing was conducted over headphones in monaural (i.e., right ear) or binaural (i.e., both ears) conditions. Results showed continuous improvement of speech reception threshold (SRT) between 6 and 15 years old and immature performance at 15 years of age for both SRTs and intelligibility benefits from more than one auditory cue. With early maturation of head shadow, the prolonged maturation of unmasking was likely driven by children's poorer ability to gain full benefits from interaural difference cues. In addition, children demonstrated a trade-off between the benefits from head shadow versus interaural differences, suggesting an important aspect of individual differences in accessing auditory cues for binaural intelligibility benefits during development. [ABSTRACT FROM AUTHOR]

Background and Aim: Subjective tinnitus is a phantom auditory perception caused by different factors and affects the patient’s quality of life. The tinnitus pathophysiology is not fully understood; therefore, there is no effective treatment for tinnitus. Along with other methods, auditory evoked potentials (AEPs) may be helpful in understanding this condition and the involved structures. This study aimed to review the applications of AEPs in tinnitus studies. Recent Findings: The studies investigating tinnitus were categorized into three groups of tinnitus pathophysiology, pre- or post-treatment/ intervention evaluation of tinnitus, and objective diagnosis of tinnitus. Contradictory and unrepeatable findings were observed in each group. Conclusion: Discrepancies in the results of AEPs studies can be due to between-group and within-group differences, lack of proper matching in terms of tinnitus etiology and hearing loss, and difference in neurophysiologic models of tinnitus. [ABSTRACT FROM AUTHOR]

To describe the profile of patients attending the Queen Elizabeth Central Hospital (QECH) audiology clinic in Malawi, over a two-year period (2016–2017). A retrospective patient record review. There were 2299 patients assessed at the QECH audiology department between January 2016 and December 2017. Adult patients' ages ranged from 18 to 94 years (M = 45.8, SD = 19.22). The mean age of children included in this study was 7.7 years (SD= 5.21). Overall, 45.4% of patients were female. Of the 61.6% of adults and 41.7% of children found to have some degree of hearing loss, 28.3% and 15.4% were fitted with hearing aids, respectively. The number of patients seen in 2017 (n = 1385) was 34% higher than that of 2016 (n = 914). This study found that demand for hearing services is increasing in this public sector Malawian audiology department but uptake of hearing aids for those in need is low. Future evaluation of service provision and treatment outcomes is needed. Results from this study can be used to inform the development of future audiology clinics in low resource settings. [ABSTRACT FROM AUTHOR]

To describe personal listening device (PLD) usage and sociodemographic variables among a nationally representative sample of Canadians and examine audiometric outcomes among a subsample. Audiometry and in-person questionnaires were used to evaluate hearing and PLD usage across age, sex, household income/education level. PLD exposure was quantified using a common occupational noise limit. A randomised sample of 10,460 respondents, aged 6–79, with audiometric analysis of a subsample (n = 4807), aged 6–29, tested between 2012 and 2015. Loud PLD usage was reported by19.5% of Canadians. The highest prevalence was among teenagers (44.2%) and young adults (36.3%). Among children, 13.1% of users listened at loud volumes. High PLD usage (equivalent to or above 85 dBA, LEX 40) among 12–19 year olds was double that of 20–29 year olds: 10.2% versus 5.1%E. Five years or more of loud PLD usage was associated with significantly higher mean hearing thresholds compared to less years. No association between loud or high PLD usage and mean thresholds were found. The majority used PLDs safely, however a small proportion reported high risk usage which will impact hearing should this pattern persist over many years. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) pandemic represented a stressful event. Objectives: The incidence of newly diagnosed Ménière's disease (MD) patients before and during COVID-19 at our Institution was calculated. Materials and methods: The period 2018-2020 was considered. Incidence was calculated as number of annual first MD diagnoses divided by the number of annual first audiological evaluations. Results: One hundred and eighty-three patients were considered. Annual incidence of MD at our institution was 1.3% in 2018, 1.2% in 2019, and 3.2% in 2020, resulting in a significant increase during COVID-19 pandemic (2018 vs. 2020, p=.00001; 2019 vs. 2020, p=.00001). MD patients in 2020 presented a higher number of vertigo attacks (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.04) and higher Dizziness Handicap Inventory questionnaire (DHI) values (2018 vs. 2020, p=.02; 2019 vs. 2020, p=.03). During COVD-19 pandemic, MD patients reported significantly higher State-Trait Anxiety Inventory (STAI) - Y1 (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.03). Conclusions and significance: A higher incidence of MD first diagnosis was calculated during COVID-19 pandemic; furthermore, MD patients presented with more vertigo attacks and higher DHI values. These could be associated with the higher state anxiety during COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The sound-field auditory steady-state response (ASSR) is a promising measure for the objective validation of hearing-aid fitting in patients who are unable to respond to behavioral testing reliably. To record the sound-field ASSR, the stimulus is reproduced through a loudspeaker placed in front of the patient. However, the reverberation and background noise of the measurement room could reduce the stimulus modulation used for eliciting the ASSR. As the ASSR level is heavily dependent on the stimulus modulation, any reduction due to room acoustics could affect the clinical viability of sound-field ASSR testing. This study investigated the effect of room acoustics on the level and detection rate of sound-field ASSR. The study also analyzed whether early decay time and an auditory-inspired relative modulation power model could be used to predict the changes in the recorded ASSR in rooms. A monaural auralization approach was used to measure sound-field ASSR via insert earphones. ASSR was measured for 15 normal-hearing adult subjects using narrow-band CE-Chirps® centered at the octave bands of 500, 1000, 2000, and 4000 Hz. These stimuli were convolved with simulated impulse responses of three rooms inspired by audiological testing rooms. The results showed a significant reduction of the ASSR level for the room conditions compared with the reference anechoic condition. Despite this reduction, the detection rates for the first harmonics of the ASSR were unaffected when sufficiently long recordings (up to 6 min) were made. Furthermore, the early decay time and relative modulation power appear to be useful predictors of the ASSR level in the measurement rooms. [ABSTRACT FROM AUTHOR]

Purpose: Lack of timely and proximal access to diagnostic hearing evaluation using auditory brainstem response (ABR) testing hampers the effectiveness of Early Hearing Detection and Intervention (EHDI) programs in the United States. This study measured the impact of a state-based quality- improvement (QI) project that provided diagnostic ABR equipment and training to educational audiologists distributed throughout Iowa in regional special education centers. Method: We used de-identified administrative data generated by the state EHDI program to analyze markers of access to early hearing health care for infants in a preproject condition ("Baseline") compared to the implementation of diagnostic ABRs at the regional special education centers ("QI Project"). Results: Our findings revealed that the QI Project was associated with improvements in timeliness of first hearing evaluation, distance traveled for first hearing evaluation, and likelihood of receiving on-guideline audiology care during the first hearing evaluation. Conclusions: Following the onset of the QI Project, infants and their families had greater access to initial hearing evaluation after failed newborn hearing screening. This improvement could have cascading effects on timeliness of later intervention among those with confirmed permanent childhood hearing loss. [ABSTRACT FROM AUTHOR]

Objective: To record crossed acoustic reflex thresholds (xART's) postoperatively from patients after surgical repair of unilateral congenital aural atresia (CAA). To seek explanations for when xARTs can and cannot be recorded. We hope to understand the implications for this central auditory reflex despite early afferent deprivation. Methods: Patients who underwent surgery to correct unilateral CAA at a tertiary academic medical were prospectively enrolled to evaluate for the presence of xART. Preoperative ARTs in the normal (non-atretic) ear, and postoperative ipsilateral ARTs (stimulus in the normal ear) and contralateral ARTs (stimulus in the newly reconstructed atretic ear; record in the normal ear) were measured at 500, 1000, and 2000 Hz. Results: Four of 11 patients with normal ipsilateral reflex thresholds preoperatively demonstrated crossed acoustic reflexes postoperatively (stimulus in reconstructed ear; record from normal ear). Four other patients demonstrated normal ipsilateral thresholds preoperatively but did not have crossed reflexes postoperatively. No reflexes (pre- or postoperatively) could be recorded in 3 patients. Crossed reflex threshold is significantly correlated with the postoperative audiometric threshold. There was no correlation between ipsilateral and contralateral reflex thresholds. Conclusion: Crossed acoustic reflexes can be recorded from some but not all postoperative atresia patients, and the thresholds for those reflexes correlate with the postoperative pure tone threshold. The presence of acoustic reflexes implies an intact CN VIII-to-opposite CN VII central reflex arc despite early unilateral sound deprivation. [ABSTRACT FROM AUTHOR]

Purpose: The acoustic source that is attended to by the listener in a mixture can be identified with a certain accuracy on the basis of their neural response recorded during listening, and various phenomena may be used to detect attention. For example, neural tracking (NT) and alpha power lateralization (APL) may be utilized in order to obtain information concerning attention. However, these methods of auditory attention detection (AAD) are typically tested in different experimental setups, which makes it impossible to compare their accuracy. The aim of this study is to compare the accuracy of AAD based on NT, APL, and their combination for a dichotic natural speech listening task. Method: Thirteen adult listeners were presented with dichotic speech stimuli and instructed to attend to one of them. Electroencephalogram of the subjects was continuously recorded during the experiment using a set of 32 active electrodes. The accuracy of AAD was evaluated for trial lengths of 50, 25, and 12.5 s. AAD was tested for various parameters of NT- and APL-based modules. Results: The obtained results suggest that NT of natural running speech provides similar accuracy to APL. The statistically significant improvement of the accuracy of AAD using a combined method has been observed not only for the longest duration of test samples (50 s, p = .005) but also for shorter ones (25 s, p = .011). Conclusions: It seems that the combination of standard NT and APL significantly increases the effectiveness of accurate identification of the traced signal perceived by a listener under dichotic conditions. It has been demonstrated that, under certain conditions, the combination of NT and APL may provide a benefit for AAD in cocktail party scenarios. [ABSTRACT FROM AUTHOR]

Committees established for the ethical review of research involving animals have become a widespread legal standard around the world. Despite many differences in their composition, powers, and institutional settings, they share many common problems related to the well-established standards of procedural justice in administrative practice. The paper adapts the general theory of procedural justice to the specific context of ethical review committees. From this perspective, the main concerns over the procedural aspects of the ethical evaluation of research projects are identified and examined. They include in particular the standards of the committees' composition, impartiality, fair hearing, appeal, transparency, and benevolence. Their proper reflection in the regulatory regimes of animal ethics committees is necessary to secure the standards of fairness of the ethical review itself. This, in turn, is a condition of the moral and social legitimacy of all administrative and quasi-administrative procedures, including the committees' operations (irrespective of whether they are legally entrusted with the task of authorizing or only evaluating research projects). [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate different auditory regions with audiological tests, based on the presumption that there may be damage to the structures in the hearing system after coronavirus disease 2019. Methods: Twenty individuals with no history of coronavirus disease 2019 and 27 individuals diagnosed with coronavirus disease 2019 were compared. Pure tone, speech and extended high-frequency audiometry, acoustic immitansmetry, transient evoked and distortion product otoacoustic emissions testing, and auditory brainstem response testing were conducted. Results: The pure tone audiometry and extended high-frequency mean threshold values were higher in the coronavirus disease 2019 group. The transient evoked otoacoustic emissions signal-to-noise ratios were bilaterally lower at 4 kHz in individuals with a coronavirus disease 2019 history. In the auditory brainstem response test, only the interpeak latencies of waves III–V were significantly different between groups. Conclusion: Coronavirus disease 2019 may cause damage to the hearing system. Patients should be followed up in the long term with advanced audiological evaluation methods in order to determine the extent and level of damage. [ABSTRACT FROM AUTHOR]

This article discusses positive therapeutic gains made with veterans whose primary treatment for post-traumatic stress disorder (PTSD) was cognitive rehabilitation using artifact corrected neurofeedback. Assessments at baseline and following 20 and 40 half-hour sessions of neurofeedback treatment identified significant improvements for auditory and visual attention using the Integrated Visual and Auditory Continuous Processing Test (IVA-2) and significant improvements in well-being based on the General Well-Being Scale (GWBS). Neurofeedback positively affected veteran's overall auditory attention with auditory test scores reflecting significant improvement following neurofeedback training sessions. Ratings of well-being significantly improved after treatment with 84% of the veterans improving five points or more on the GWBS. Improvements in well-being were found to be significantly correlated with increases in veterans' overall auditory attention and auditory processing speed. By identifying and improving auditory and visual processing difficulties in veterans with PTSD using neurofeedback, improvements in cognitive functioning may hold promise for enhanced employment outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this study was to (i) develop a model that predicts hearing aid (HA) use and (ii) determine if model fit is improved by adding factors not typically collected in audiological evaluations. Two models were created and evaluated. The "clinical" model used factors typically collected during audiologic clinical evaluations. The "expanded" model considered additional clinical, health and lifestyle factors to determine if the model fit could be improved (compared to clinical model). Models were created with least absolute shrinkage and selection operator (LASSO) logistic regression with 10-fold cross validation. Predictive ability was evaluated via receiver operating characteristic curves and concordance statistics (c-statistics). This study included 275 participants from the Beaver Dam Offspring Study, a prospective longitudinal cohort study of aging, with a treatable level of hearing loss and no HA use at baseline. The clinical and expanded models report predictors important for HA use. The c-statistics of the clinical (0.80) and expanded (0.79) models were not significantly different (p = 0.41). Similar predictive abilities of models suggest audiological evaluations perform well in predicting HA use. [ABSTRACT FROM AUTHOR]

Background Broadband noise (nonnotched) and notched noise are common sound sources in sound therapy for tinnitus relief. Studies on sound therapy using nonnotched or notched stimuli have reported large and small tinnitus improvements depending on the participant. However, the more effective sound source remains unclear given the among-study methodology differences. Purpose This study aimed to evaluate the tinnitus relief effects of sound therapy using stimuli with different spectral characteristics. Research Design This was a prospective study involving within-subject (baseline vs. 12-month follow-up) measurements for two groups (notched noise group vs. broad- band noise group). Study Sample We enrolled 30 adults with subjective and tonal tinnitus (notched noise group: 16, broadband noise group: 14). Intervention The participants underwent 3-hour daily sound therapy using either notched noise or broadband noise for 12 months. The stimulus level for sound therapy was set to each participant's mixing point. Data Collection and Analysis Tinnitus loudness and the Korean version of the Tinnitus Primary Function Questionnaire score were measured at baseline and at the 12-month follow-up time point. Results Both groups showed a significant improvement in tinnitus loudness and the Korean version of the Tinnitus Primary Function Questionnaire score. Conclusion Notched and nonnotched stimuli are equally effective at themixing point in sound therapy for tinnitus relief. Individuals with difficulties in tinnitus frequency measurement could easily undergo sound therapy using nonnotched stimuli. [ABSTRACT FROM AUTHOR]