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This article provides a comprehensive overview of how the ears and brain work together to process sound. It explains that when sound enters our ears, it is converted into electrical signals that the brain can interpret. The brain uses nerve cells to separate and recognize different sounds, determining their loudness and direction. The article discusses the different parts of the ear involved in this process and highlights the role of the brain in decoding and understanding the electrical signals. It also emphasizes that our understanding of sound is influenced by our prior knowledge and what we see. The article further explores how the brain processes and separates different sounds, using mechanisms like the medial superior olives to determine location and separate sounds. It concludes by emphasizing the importance of understanding how we hear for effective treatment of hearing problems and the development of technologies like mp3 files and artificial speech recognition. The authors, who include experts in auditory neuroscience and a children's author, provide their perspectives and contact information for further inquiries. [Extracted from the article]

Objectives. When performing middle ear operations, such as ossiculoplasty or stapes surgery, patients and surgeons expect an improvement in air conduction (AC) hearing, but generally not in bone conduction (BC). However, BC improvement has often been observed after surgery, and the present study investigated this phenomenon. Methods. We reviewed the preoperative and postoperative surgical outcomes of 583 patients who underwent middle ear surgery. BC improvement was defined as a BC threshold decrease of >15 dB at two or more frequencies. Subjects in group A underwent staged ossiculoplasty after canal wall up mastoidectomy (CWUM), group B underwent staged ossiculoplasty after canal wall down mastoidectomy (CWDM), group C underwent ossiculoplasty only (thus, they had no prior history of CWUM or CWDM), and group D received stapes surgery. We created a hypothetical circuit model to explain this phenomenon. Results. BC improvement was detected in 12.8% of group A, 9.1% of group B, and 8.5% of group C. The improvement was more pronounced in group D (27.0%). A larger gain in AC hearing was weakly correlated with greater BC improvement (Pearson’s r=0.395 in group A, P

Abstract Background The vestibular system can perceive sound at high intensity levels. The recording of vestibular evoked myogenic potentials (VEMPs) is one of the clinical techniques that capture the vestibular system when activated by sound. In healthy individuals, it has been demonstrated that VEMP thresholds are lower when using low-frequency stimuli, particularly 500 Hz tone burst. Aging affects frequency tuning, causing shift to higher frequencies. Methods This study was cross-sectional, which included 80 normal healthy individuals. Each participant in the study were subjected to cervical vestibular evoked myogenic potential (cVEMP) testing using air and bone conduction as a mode of stimulation. The following cVEMP parameters were assessed: cVEMP inter-frequency peak amplitude ratio (FAR): the ratio of peak-to-peak amplitude between 500 Hz and 1000 Hz in the same ear (1000 Hz/500 Hz FPA). Also, rectified FAR is a method of normalizing the amplitude of the VEMP response to the degree of muscle contraction as determined by EMG. Results There were differences among the 5 age groups that were statistically different regarding FAR and rFAR of cVEMP when using air and bone conduction stimuli. Conclusion In this study, we provided age norms for frequency amplitude ratio (FAR) (1000/500 Hz) of cVEMP using AC and BC stimuli. Participants above the 50 years age group showed significantly larger FAR and rectified FAR than the younger age groups in both the cVEMP. Air and bone conduction stimuli yielded similar FAR results and can be both used in testing.

Abstract Objectives Microtia and aural atresia are congenital ear anomalies with a wide‐ranging spectrum of phenotypes and varied functional and psychosocial consequences for patients. This study seeks to analyze the management of microtia‐atresia patients at our center over a 20‐year period and to propose recommendations for advancing microtia‐atresia care at a national level. Methods We performed a retrospective analysis of data from patients presenting to the Massachusetts Eye and Ear (Boston, MA) for initial otolaryngology consultation for congenital microtia and/or aural atresia between 1999 and 2018. Results Over the 20‐year study period, 229 patients presented to our microtia‐atresia center at a median age of 7 years. The severity of microtia was most commonly classified as grade III (n = 87, 38%), 61% (n = 140) of patients had complete atresia, the median Jahrsdoerfer grading scale score was 6 (range 0–10), and 81 patients (35%) underwent surgery for microtia repair. For hearing rehabilitation, 30 patients (64%) underwent bone conduction device implantation and 17 patients (36%) underwent atresiaplasty. The implementation of an interdisciplinary, longitudinal care model resulted in an increase in patient (r = 0.819, p

The present study investigates formant frequencies and vowel space area in Jordanian hearing-impaired individuals who received cochlear implants. To achieve this task, they were compared with their hearing aids and normal-hearing peers. The study involved 60 participants aged between 7 and 11 years, consisting of 20 cochlear implant (CI) users, 20 hearing aid (HA) users, and 20 normal-hearing (NH) children. All participants were native speakers of Jordanian Arabic. The study measured the fundamental frequency (F0), the first, second, and third formant frequencies (F1–F3) of the five long vowels: /i:/, /e:/, /a:/, /o:/, and /u:/ using Praat software (version 6.1.05). One-way repeated measure (ANOVA) and post hoc Tukey tests were used to compare the differences between the three groups. The results revealed significant differences between the three groups in the degree of vowel height and backness for all the long vowels. The vowel space in HA users was found to be smaller than in CI users. HA users had difficulty varying their tongue position in both the high–low and the front–back dimensions, while CI users had difficulty varying their tongue position only in the front–back dimension. The study also examined errors in long vowels and diphthongs. The findings indicated that after cochlear implantation, the formants of the vowels produced by hearing-impaired speakers shifted closer to those produced by their NH peers, and CI users had a greater vowel space compared to HA users. This research could potentially contribute to the development of effective interventions for hearing-impaired individuals and could provide insights for the design of speech therapy programs that aim to improve vowel production abilities. [ABSTRACT FROM AUTHOR]

Exact placement of bone conduction implants requires avoidance of critical structures. Existing guidance technologies for intraoperative placement have lacked widespread adoption given accessibility challenges and significant cognitive loading. The purpose of this study is to examine the application of augmented reality (AR) guided surgery on accuracy, duration, and ease on bone conduction implantation. Five surgeons surgically implanted two different types of conduction implants on cadaveric specimens with and without AR projection. Pre- and postoperative computer tomography scans were superimposed to calculate centre-to-centre distances and angular accuracies. Wilcoxon signed-rank testing was used to compare centre-to-centre (C-C) and angular accuracies between the control and experimental arms. Additionally, projection accuracy was derived from the distance between the bony fiducials and the projected fiducials using image guidance coordinates. Both operative time (4.3 ± 1.2 min. vs. 6.6 ± 3.5 min., p = 0.030) and centre-to-centre distances surgery (1.9 ± 1.6 mm vs. 9.0 ± 5.3 mm, p < 0.001) were significantly less in augmented reality guided surgery. The difference in angular accuracy, however, was not significantly different. The overall average distance between the bony fiducial markings and the AR projected fiducials was 1.7 ± 0.6 mm. With direct intraoperative reference, AR-guided surgery enhances bone conduction implant placement while reduces operative time when compared to conventional surgical planning. [ABSTRACT FROM AUTHOR]

Objectives: To characterize cervical vestibular evoked myogenic potentials (c-VEMPs) in bone conduction (BC) and air conduction (AC) in healthy children, to compare the responses to adults and to provide normative values according to age and sex. Design: Observational study in a large cohort of healthy children (n = 118) and adults (n = 41). The c-VEMPs were normalized with the individual EMG traces, the amplitude ratios were modeled with the Royston-Wright method. Results: In children, the amplitude ratios of AC and BC c-VEMP were correlated (r = 0.6, p < 0.001) and their medians were not significantly different (p = 0.05). The amplitude ratio was higher in men than in women for AC (p = 0.04) and BC (p = 0.03). Children had significantly higher amplitude ratios than adults for AC (p = 0.01) and BC (p < 0.001). Normative values for children are shown. Amplitude ratio is age-dependent for AC more than for BC. Confidence limits of interaural amplitude ratio asymmetries were less than 32%. Thresholds were not different between AC and BC (88 ± 5 and 86 ± 6 dB nHL, p = 0.99). Mean latencies for AC and BC were for P-wave 13.0 and 13.2 msec and for N-wave 19.3 and 19.4 msec. Conclusion: The present study provides age- and sex-specific normative data for c-VEMP for children (6 months to 15 years of age) for AC and BC stimulation. Up to the age of 15 years, c-VEMP responses can be obtained equally well with both stimulation modes. Thus, BC represents a valid alternative for vestibular otolith testing, especially in case of air conduction disorders. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the middle and inner ear function and hearing status of Ankylosing spondylitis (AS) patients. Methods: One hundred twenty-four ears of 62 patients with AS and 90 ears (control group) of 45 healthy subjects were included in the study. The hearing levels of the participants were assessed with pure tone and high-frequency audiometry at the octave frequency between 250 and 16,000 Hz. The absorbance rates and resonance frequencies of middle ear were measured with the wideband tympanometry (WBT) test. AS group was divided into subgroups based on the disease activity, duration of follow-up, medications used for AS, and the subgroups were compared according to hearing status and absorbance and resonance frequencies of middle ears. Results: A statistically significant difference was found between the AS and control groups in terms of air and bone conduction thresholds at frequencies of 250, 500, 1000, 2000, and 4000 Hz and the mean PTA1, PTA2, and PTA3 values (p < 0.05). In contrast, no statistically significant difference was observed between two groups in terms of high-frequency thresholds (8000–16,000 Hz). Although the middle ear resonance frequency obtained from the WBT test was higher in the AS group compared to the control group, no significant difference was observed (p > 0.05). The severity of disease adversely affected the hearing threshold at 250, and 500 Hz for air conduction, at 500 Hz for bone conduction threshold, and at PTA1 (p < 0.05). The duration and severity of disease did not affect absorbance values of WBT (p > 0.05). Conclusion: To our knowledge, this is the first study to demonstrate the effects of AS patients on the middle ear function with WBT and to report middle ear absorbance values and resonance frequency changes in AS patients. The higher resonance frequency values found by WBT in AS patients may be due to the stiffness that develops as a result of middle ear involvement. According to pure tone and high-frequency audiometry findings, it has been seen that AS leads to SNHL especially at low frequencies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the wideband tympanometry (WBT) findings in the elderly with presbycusis who have normal outer and middle ears according to otoscopic examination and traditional tympanometry, and to determine whether there is a relationship between the middle ear wideband absorbance value and the pure tone air–bone gap (ABG) observed especially at mid-high frequencies in the elderly. Methods: The study included 30 elderly with presbycusis (> 65 years old, presbycusis group) and 30 healthy individuals (control group) between the ages of 18 and 55. Pure tone air conduction and bone conduction thresholds of all participants were determined and WBT was applied to all participants. Resonance frequency (RF), absorbance ratios at peak pressure (PPAR) and ambient pressure (APAR) values were analyzed. Results: The RF value of the presbycusis group was lower than the control group (p < 0.05). APAR and PPAR values at 2000 and 4000 Hz and mean absorbance values of the presbycusis group were lower than the control group (p < 0.05). APAR was higher at 500 Hz in males than females (p < 0.05), but there was no difference between genders in RFs (p > 0.05). A moderate negative correlation was observed between ABG and both PPAR and APAR at 4000 Hz in presbycusis group (p < 0.05). Conclusion: it was determined that there was a decrease in RF and absorbances at 2000 and 4000 Hz in the elderly with presbycusis. Aging affects not only the inner ear but also the conduction mechanism of the middle ear. Our findings may be effective in a more accurate and reliable interpretation of WBT in the elderly with presbycusis. [ABSTRACT FROM AUTHOR]

Purpose: To compare hearing results and complication rates between two groups of patients operated on by endoscopic stapes surgery (ESS) for otosclerosis, either with CO2 fiber laser or microdrill. Methods: A case–control study was performed. All consecutive cases of CO2 fiber laser ESS operated at a single center during the period 2017–2020 (case group) were matched to a control group of patients operated by traditional technique, according to year of surgery, preoperative mean air–bone gap, sex and age. Audiological data from preoperative and postoperative examinations and complication rates were compared. Results: 46 cases were included. Mean operative time was significantly longer in the laser cohort (65 min) than in the drill one (45 min) (p = 0.003). Similar results were found in the two groups regarding the mean postoperative BC-PTA. The high-frequency bone conduction resulted significantly higher in the laser group (p = 0.002), suggesting an overclosure effect in the laser group. Consistently, a significant improvement of the BC-PTA threshold at 2000 Hz postoperatively was found in the laser group (p = 0.034). The postoperative AC-PTA significantly improved in both groups at all frequencies (p < 0.05), except for the AC threshold at 8 kHz. Similar rates of complications were found in the two groups. Conclusion: This study is the first to compare hearing results and complications between CO2 fiber laser and microdrill in ESS. Our results demonstrated similar functional outcomes between the two groups, confirming ESS as safe and effective, regardless of the technique used. [ABSTRACT FROM AUTHOR]

Purpose: To examine the subjective and objective audiological benefits of the Osia system compared to devices commonly implanted prior to the introduction of this system. Methods: Osia recipients with either conductive hearing loss (CHL/MHL) (n = 9) or single-sided deafness (SSD) (n = 8) who underwent surgery from February 2021 to March 2022 were prospectively recruited. The audiological outcomes and usage rate of Osia implantees were compared with those of retrospectively recruited patients implanted with other devices (n = 50). The subjective satisfaction of the Osia implantees was also evaluated through questionnaires. Results: All users of the Osia system were classified as regular users. In the CHL/MHL group, the effective gain of the Osia system (11.1 ± 14.9 dB) surpassed that of the Baha and Bonebridge (− 2.7 ± 12.6 dB) at 2 kHz (p = 0.01, Mann–Whitney U test). Among the devices, the Osia system tended to tolerate the worst bone conduction thresholds, up to the level of 61 dB. In the SSD group, the functional gain of Osia at 4 kHz (37.5 ± 3.1 dB) was higher than that of the Baha and Bonebridge group (26.9 ± 3.0 dB) (p = 0.05, Mann–Whitney U test). Conclusion: The Osia system yielded larger audiological gain than the Baha Attract and Bonebridge devices, especially at high frequencies, leading to substantially higher compliance. The Osia system tended to have the strongest tolerance to aggravated bone conduction thresholds among the available transcutaneous bone conduction hearing implants. Therefore, the Osia system could potentially be a good option for CHL/MHL patients with bone conduction thresholds of 50 dB HL or more, as well as patients with SSD. [ABSTRACT FROM AUTHOR]

Purpose: To compare the audiological performances of Turkey's most up-to-date bone conduction implant processors. Methods: Twenty-six bone-anchored hearing instrument users, thirteen in each group, were evaluated for speech understanding in quiet and several signal-to-noise ratios. Results: We noticed the differences at 0.5 and 1 kHz measurements in free field frequency specific test, aided SRT scores, non-adaptive and adaptive matrix test results for a few conditions created a statistically significant difference in favor of Baha-6®. Conclusions: Both processors offer positive gains to their users in noisy and silent conditions. However, the data showed statistically significant differences for some measurements that may be critical for patients in daily practice. [ABSTRACT FROM AUTHOR]

Introduction: Bone-anchored hearing devices (BAHD) are well-known good solution for single-sided deafness (SSD). Despite power extension of recently introduced BAHD with implanted active transducer, with indications up to 65 dB Hl of bone conduction (BC) threshold on the implanted side, their indications for SSD still remain better than 25 dB on the good ear, with regards to bone conduction thresholds. The aim of this study was to assess the possibility to enlarge BAHD indications for SSD by means of a newly proposed candidacy evaluation protocol, which includes a new software-aided method. Methods: 20 SSD patients (mean age 56 years, 9 females, and 11 males) were divided into two groups: group A (10 patients, BC <25 dB Hl on the hearing side) and group B (10 patients, BC between 25 and 35 dB Hl). Recipients were submitted to bisyllabic words speech audiometry in silence and to authors' newly proposed IFastSRT50 test by means of software which shift noise intensity of a single word list on the basis of correct recipient recognition responses. A sound speaker for signal (bisyllabic words) and noise (babble) was disposed at 1 m from the deaf side of the patient. An earphone covering only the good ear of the recipient was used in order to perform its air conduction masking with white noise. A BAHD test device was disposed on the mastoid of the deaf side. Both signal and masking intensities were set to 55 dB SPL in order to mask airway conduction on the good ear without masking its bone way interaural conduction from the BAHD tester. Results: With BAHD tester turned off, no recognition was detected. Speech audiometry with BAHD tester turned on revealed mean values of 92% for group A and 89% for group B, with a difference of 3.0% (χ2 = 0.285 and p = 0.5935). As for IFastSRT50 with BAHD tester turned on, mean signal-to-noise ratio value to obtain 50% of recognition was −6.89 for group A and −6, with a difference of 0.89 (t = 1,201 and p = 0.2453). Conclusion: BAHD are confirmed to be a good solution for SSD cases. The absence of statistically significant differences in our two tested groups suggests that newer implanted active transducer device indications should be extended up to 35 dB Hl on the hearing ear. The IFastSRT50 is a reliable and quick method to enhance preoperative candidacy evaluation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate whether induction of temporary threshold shift (TTS) with aspirin prior to cisplatin exposure can prevent or minimize cisplatin detrimental effects on hearing. Methods: We randomly divided BALB mice into three groups: (1) cisplatin only, (2) aspirin only, and (3) combined aspirin/cisplatin. Cisplatin was administered as a single intraperitoneal injection of 14 mg/kg. Aspirin was administered for three weeks via intraperitoneal injection of 200 mg/kg sodium salicylate, twice daily. Air conduction thresholds were recorded using Auditory Brainstem Responses (ABR). Cochleae were harvested and cochlear hair cells were counted using a scanning electron microscope (SEM). Results: Aspirin-induced TTS have reached an average of 30.05±16.9 dB after 2 weeks. At 60 days, cisplatin-only treated mice experienced an average threshold shifts of 50.7 dB at 4 kHz, 35.16 dB at 8 kHz, 70 dB at 16 kHz, 53.1 dB at 32 kHz. All threshold shifts were significantly worse than for cisplatin/aspirin treated mice with TTS of 11.85 dB at 4 kHz, 3.58 dB at 8 kHz, 16.58 dB at 16 kHz, 20.41 dB at 32 kHz (p < 0.01). Cochlear cell count with SEM has shown reduction in the number of both inner and outer hair cells in the mid-turn in cisplatin treated mice. Conclusion: Aspirin induced TTS can protect from cisplatin-induced ototoxicity. This beneficial effect was demonstrated by auditory thresholds as well as SEM. Larger pre-clinical and clinical studies are still needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Objective: There is no consensus in the literature regarding the relationship between high-resolution computed tomography findings and hearing thresholds in pure-tone audiometry in otosclerosis. This study evaluated the association between high-resolution computed tomography findings and pure-tone audiometry in otosclerosis in the spongiotic phase. Methods: A cross-sectional study was conducted of 57 ears with surgically confirmed stapes fixation and tomographic findings. Air conduction and bone conduction thresholds on audiometry, and air–bone gap, were analysed. Results: There were no correlations between sites affected by otospongiosis and air conduction threshold, bone conduction threshold or air–bone gap in the analysed tomographic images, but the diameter of the otospongiotic focus was greater in the presence of extension of the otospongiotic foci to the cochlear endosteum. Conclusion: There were no relevant associations between high-resolution computed tomography findings and pure-tone audiometric measurements. However, the diameter of the otospongiotic focus was greater in the presence of extension of the otospongiotic foci to the cochlear endosteum. [ABSTRACT FROM AUTHOR]

Bone conduction (BC) stimulation has mainly been used for clinical hearing assessment and hearing aids where stimulation is applied at the mastoid behind the ear. Recently, BC has become popular for communication headsets where the stimulation position often is close to the anterior part of the ear canal opening. The BC sound transmission for this stimulation position is here investigated in 21 participants by ear canal sound pressure measurements and hearing threshold assessment as well as simulations in the LiUHead. The results indicated that a stimulation position close to the ear canal opening improves the sensitivity for BC sound by around 20 dB but by up to 40 dB at some frequencies. The transcranial transmission ranges typically between −40 and −25 dB. This decreased transcranial transmission facilitates saliency of binaural cues and implies that BC headsets are suitable for virtual and augmented reality applications. The findings suggest that with BC stimulation close to the ear canal opening, the sound pressure in the ear canal dominates the perception of BC sound. With this stimulation, the ear canal pathway was estimated to be around 25 dB greater than other contributors, like skull bone vibrations, for hearing BC sound in a healthy ear. This increased contribution from the ear canal sound pressure to BC hearing means that a position close to the ear canal is not appropriate for clinical use since, in such case, a conductive hearing loss affects BC and air conduction thresholds by a similar amount. [ABSTRACT FROM AUTHOR]

Introduction: Chronic otitis media is relatively common and potentially dangerous disease of the ear. It is often characterized by cholesteatoma that causes local destruction and osseous erosion leading to complications. Its management is mainly surgical, mostly a canal wall up and down tympanomastoid surgery. High resolution computed tomography (HRCT) is the imaging modality of choice for evaluation of middle ear structures and pathology. The aim of this study is to identify causes of failure and its management with special reference to CT scan. Aims: Evaluation of different causes of revision tympanomastoid surgery, assessment of their outcome, and ascertaining the possible measures to prevent further recurrence. Materials and Methods: This Prospective descriptive study conducted at department of ENT, IPGMER & SSKM Hospital, Kolkata from 1year&6 months (April, 2020 to September, 2021). Result: 30 (60.0%) patients had Modified Radical Mastoidectomy Surgery and 20 (40.0%) patients had Radical Mastoidectomy Surgery. 41 (82.0%) patients had Cavity obliteration Palva flap. 23 (46.0%) patients had Cavity obliteration Bone dust. 26 (52.0%) patients had Cavity obliteration Cartilage. 41 (82.0%) patients had Adequate in Conchomeatoplasty Size Post-operative findings 1 Month. A significant improvement in mean air conduction level, mean bone conduction level, and mean air-bone gap (ABG) was found postoperatively (p < 0.05). For all types of ossicular chain reconstruction, a significant improvement in mean Pure Tone Average was observed (p < 0.05). Conclusion: A revision canal wall down surgery, if performed successfully following all the basic principles of tympanomastoid surgery, can help achieve a safe and dry ear and can significantly improve the subjective well-being of the patients. [ABSTRACT FROM AUTHOR]

Research on the otolith organs remains inconclusive. This study seeks to further elucidate utricular function in patients with Meniere's disease (MD) in three ways: (1) We aimed to disambiguate the role of the Subjective Visual Vertical (SVV) and Ocular Vestibular Evoked Myogenic Potential (o-VEMP) tests regarding which utricular subsystem each is measuring. (2) We sought to characterize the acute and chronic state of MD by identifying differences in the relationship of SVV and o-VEMP results across patients with acute and chronic MD. (3) We attempted to find a machine-learning algorithm that could predict acute versus chronic MD using SVV and o-VEMP. A prospective study with ninety subjects. (1) SVV and o-VEMP tests were found to have a moderate linear relationship in patients with acute MD, suggesting each test measures a different utricular subsystem. (2) Regression analyses statistically differed across the two patient populations, suggesting that SVV results were normalized in chronic MD patients. (3) Logistic regression and Naïve Bayes algorithms were found to predict acute and chronic MD accurately. A better understanding of what diagnostic tests measure will lead to a better classification system for MD and more targeted treatment options in the future. [ABSTRACT FROM AUTHOR]

The primary objective of the current study was the validation of a cloud-centralized audiometry system for clinical practice. A cross-sectional study design was used. A convenience sample of patients (>10 years old) booked for follow-up appointments were invited to participate. Participants completed both conventional and online digital audiometry in a standard sound treated clinic space during a single clinic visit; tests were completed in random order. Data for both ears were included. Patients were from one of three audiological practices. A total of 41 participants completed both audiometric tests. Validation study results showed that the mean difference between the two audiometric test results remained within 5 dB HL for both air and bone conduction thresholds at all tested frequencies. Online digital audiometry has been demonstrated as a clinically accurate method for hearing assessment. [ABSTRACT FROM AUTHOR]

This study investigated the use of bone-conduction headsets paired to a wireless, remote microphone on speech discrimination and word identification for children with normal hearing. Children were tested with and without the headset, using the McCormick speech discrimination test in quiet and in speech-shaped noise to measure word-discrimination thresholds. Additionally, open-set word identification in noise was assessed while children were simultaneously engaged in a visual-monitoring task. Twenty normal-hearing children, aged 4–11 years. Median word-discrimination threshold in quiet (n = 20) was 20.5 dB(A) without a headset and 11.5 dB(A) with a headset (Z = –3.826, p = 0.0001). In noise, the median word-discrimination threshold (n = 20) was 52 dB(A) without a headset and 40.5 dB(A) with a headset (Z = –3.926, p< 0.0001). For open-set word identification (n = 11), children performed significantly better with a headset than without it, with an average improvement of 23 percentage points (t(10) = −5.227, p = 0.0004, two tailed). A bone-conduction headset paired to a Bluetooth microphone improved discrimination of distant speech in quiet and in noise and open-set word identification in noise. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of wearing a face mask on word recognition in hearing-impaired listeners. Word recognition scores were obtained in quiet and in different signal-to-noise ratios (SNRs 0, +5, and +10 dB) using two listening conditions (with N95 mask and with no-mask). Participants were forty-six listeners with normal hearing sensitivity and thirty-nine listeners with mild to moderately severe sensorineural hearing loss. Results showed that wearing a face mask affected word recognition and that this effect was greater for listeners with hearing impairment than that observed for listeners with normal hearing sensitivity. The extent of this effect was also dependent on the SNR conditions such that the effect of wearing a face mask was worse in adverse listening conditions. Overall, this study demonstrated that face mask can disrupt speech intelligibility possibly by degrading some acoustical features which may pose substantial difficulties for those with hearing impairment. [ABSTRACT FROM AUTHOR]

Objective measurement of audibility (verification) using bone conduction devices (BCDs) has long remained an elusive problem for BCDs. For air conduction hearing aids there are well-defined and often used objective methods, and the aim of this study is to develop an objective method for BCDs. In a novel setup for audibility measurements of bone-anchored hearing aid (BAHA) attached via a soft band, we used a skin microphone (SM) on the forehead measuring in-situ sound field thresholds, maximum power output (MPO) and international speech test signal (ISTS) responses. Five normal-hearing persons. Using the electrical output of SM it was possible to objectively measure the audibility of a skin drive BCD, presented as an eSPL-o-gram showing thresholds, MPO and ISTS response. Normalised eSPL-o-gram was verified against corresponding FL-o-grams (corresponding force levels from skull simulator and artificial mastoid (AM)). The proposed method with the SM can be used for objective measurements of the audibility of any BCDs based on thresholds, MPO and speech response allowing for direct comparisons of hearing and BCD output on the same graph using an eSPL-o-gram. After normalisation to hearing thresholds, the audibility can be assessed without the need for complicated calibration procedures. [ABSTRACT FROM AUTHOR]

Introduction Otosclerosis is a common cause of conductive hearing loss in the adult population that is caused by fixation of the stapes footplate. Cochlear otosclerosis may also present with sensorineural or mixed hearing loss. Surgery is the definitive treatment of choice and, during the procedure, sealing of the oval window with autologous tissue graft around the stapes prosthesis has been routinely done to improve hearing outcome and to mitigate postoperative complications. Objective To evaluate the efficacy of two different types of autologous tissue (vein or fat) grafts as oval window sealing materials in stapedotomy in improving short-term hearing outcomes. Methods In our study, 70 patients with otosclerosis who underwent primary stapedotomy were included. They were divided into group 1 (vein graft) and group 2 (fat graft) based on the type of sealing material used. All patients were followed-up at the end of 3 months, undergoing an audiometric examination to assess the hearing outcome. Results A total of 80% (n = 28) of the patients in group1 had an air-bone gap (ABG) closure < 10dB, and, in group 2, 85.7% had an ABG closure < 10 dB; this difference was found to be statistically insignificant. A total of 42.9% (n = 15) of the patients in group 1 and of 31.4% (n = 11) in group 2 had a significant improvement in bone conduction, while 14.3% (n = 5) of the patients in group 1 and 17.1% (n = 6) in group 2 had worsening of average bone conduction postoperatively, which was found to be statistically insignificant. Conclusion Both vein and fat grafts had comparable effects on hearing outcomes when used as sealing materials in stapedotomy. [ABSTRACT FROM AUTHOR]

The objective of this retrospective study was to present the experience on the management of labyrinthine fistula secondary to chronic otitis media in a tertiary center. 263 patients, who underwent tympanomastoidecomy, in Centro Hospitalar Universitário do Porto, between 2015 and 2020 were reviewed, to select only those with labyrinthine fistulas. 26 patients (9.89%) had cholesteatoma complicated by fistula of the lateral semicircular canal. Most frequent symptoms were unspecific, such as otorrhea, hearing loss and dizziness. Preoperative high-resolution computed tomography predicted fistula in 54%. Using the Dornhoffer and Milewski classification, 10 cases (38.46%) were identified as stage I, 15 (57.69%) at stage II, and 1 (3.85%) as stage III. The choice between open or closed surgical procedure was independent of the type of fistulae. The cholesteatoma matrix was completely removed from the fistula and immediately covered by autogenous material. In one patient matrix was left over the fistula. After surgery, hearing (bone conduction) was preserved or improved in 73% of the patients. There was no statistically significant relationship between the extent of the labyrinthine fistula, type of material used in fistula repair and the hearing outcome. Also, we didn't find a statistically significant relationship between extent of the labyrinthine fistula and the presence of facial nerve canal dehiscence, tegmen timpani erosion, sigmoid sinus exposure or ossicular bone erosions. In conclusion, a complete and nontraumatic removal of cholesteatoma matrix over the fistula in a single-staged procedure, is a safe and effective procedure, which achieves a hearing preservation or improvement in most cases. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of changes in the plasma calcium (Ca) level on pure tone audiometry hearing thresholds and the signal-to-noise ratio (SNR) values in otoacoustic emission measurements in patients with primary hyperparathyroidism. Material and Methods: This prospective study included patients aged >18 years, who were diagnosed with hyperparathyroidism and underwent surgery between January 2021-September 2022. The patients had no history of hearing loss, ear surgery, or trauma, and did not have tinnitus. Before parathyroid adenoma excision and at 1 month postoperatively, puretone audiometry, distortion product otoacoustic emission (DPOAE), transient otoacoustic emission (TEOAE) and tympanometric measurements were taken. Venous blood samples were taken from all the patients and parathyroid hormone (PTH), Ca, albumin, phosphorus, blood urea nitrogen and creatinine levels were determined. Results: Evaluation was made of 42 ears of 21 patients with a mean age of 44.2±10.3 (range, 21-63 years) years. The mean PTH and Ca++ values were measured as 289±225.9 pg/mL and 11.52±0.72 mg/dL preoperatively, and 79±73.1 pg/mL and 9.34±0.36 mg/dL at 1 month postoperatively (p<0.001, p<0.001). The air and bone conduction thresholds were determined to be 14.12±4.06 dB and 9±4.08 dB preoperatively, and 14.56±4,76 dB and 9.43±5.01 dB respectvely, postoperatively (p=0.151, p=0.610). No statistically significant difference was determined between the preoperative and postoperative hearing thresholds, TEOAE, and SNR values in DPOAE. Conclusion: There is a need for further studies to evaluate the relationship between the perilymph Ca content associated with the cerebrospinal fluid Ca level and the plasma Ca level. According to the results of this study, hypercalcemia had no significant effect on hearing and otoacoustic emission. [ABSTRACT FROM AUTHOR]

Aim: This European multicentric study aimed to prove safety and performance of the Bonebridge BCI 602 in children and adults suffering from either conductive hearing loss (CHL), mixed hearing loss (MHL), or single-sided sensorineural deafness (SSD). Methods: 33 patients (13 adults and 10 children with either CHL or MHL and 10 patients with SSD) in three study groups were included. Patients were their own controls (single-subject repeated measures), comparing the unaided or pre-operative to the 3-month post-operative outcomes. Performance was evaluated by sound field thresholds (SF), word recognition scores (WRS) and/or speech reception thresholds in quiet (SRT) and in noise (SNR). Safety was demonstrated with a device-specific surgical questionnaire, adverse event reporting and stable pure-tone measurements. Results: The Bonebridge BCI 602 significantly improved SF thresholds (+ 25.5 dB CHL/MHL/SSD), speech intelligibility in WRS (+ 68.0% CHL/MHL) and SRT in quiet (− 16.5 dB C/MHL) and in noise (− 3.51 dB SNR SSD). Air conduction (AC) and bone conduction (BC) thresholds remained stable over time. All adverse events were resolved, with none unanticipated. Mean audio processor wearing times in hours [h] per day for the CHL/MHL group were ~ 13 h for adults, ~ 11 h for paediatrics and ~ 6 h for the SSD group. The average surgical length was 57 min for the CHL/MHL group and 42 min for the SSD group. The versatility of the BCI 602 (reduced drilling depth and ability to bend the transition for optimal placement) allows for treatment of normal, pre-operated and malformed anatomies. All audiological endpoints were reached. Conclusions: The Bonebridge BCI 602 significantly improved hearing thresholds and speech understanding. Since implant placement follows the patient's anatomy instead of the shape of the device and the duration of surgery is shorter than with its predecessor, implantation is easier with the BCI 602. Performance and safety were proven for adults and children as well as for the CHL/MHL and SSD indications 3 months post-operatively. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to analyze the hearing outcomes and quality of life in a series of 52 patients affected by conductive or mixed hearing loss and treated with Bonebridge®. Methods: 52 of 71 patients implanted with Bonebridge® between October 2012 and January 2022, were included in the study. We compared the air conduction thresholds at the frequencies 500, 1000, 2000, 3000, 4000 Hz, the SRT50% and the World Recognition Score at an intensity of 50 dB with and without the implant. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was employed to assess the quality of life of patients. Results: The liminal tone audiometry (free field) pure tone average for air conduction after 6 months with the implant was 35.12 dB, obtaining a mean gain of 31.83 dB. With Bonebridge®, the mean SRT was 34.17 dB, whereas before the surgery no patient achieved 50% of correct answers at a sound intensity of 50 dB. The world recognition score at 50 dB changed from 11% without the implant to 85% with it. We observed one case of implant failure and one case of implant exposure. The APHAB questionnaire showed an improvement after implantation in practically all the subscales. Conclusions: The hearing outcomes and the subjective benefits reported by patients obtained in our study are similar to those published in the literature. Bonebridge® represents an excellent method for the rehabilitation of patients with conductive and mixed hearing loss, showing a low rate of complications. [ABSTRACT FROM AUTHOR]

Summary: Premature infants often require prolonged hospitalisation in the neonatal intensive care unit (NICU) where they are exposed to adverse noise that may disrupt sleep and further compromise recovery and developmental outcomes. This single‐session trial assessed the effects of a novel circumaural hearing protection device (DREAMIES®; NEATCAP Medical LLC) on sleep in 10 premature infants (mean 34.1 weeks GA) in a Level III NICU. Using polysomnography (PSG), the infant's sleep was compared between three interfeed periods throughout which DREAMIES® was ON or OFF. Each infant received the same condition order, OFF1‐ON‐OFF2. The PSG 30 s epochs were scored by a rater masked to the condition as Quiet Sleep, Active Sleep, Indeterminate Sleep, and Wake. There was a 14.1% increase in sleep from OFF1 to ON (p = 0.05) and an 18.4% decrease in sleep from ON to OFF2 (p = 0.02); an analogous inverse effect was observed for wake (χ2 = 5.03, p = 0.08). There was a main effect of DREAMIES on active sleep (χ2 = 7.4, p = 0.025) due to more active sleep for ON1 (46%) compared with OFF2 (32%; p = 0.074). No significant effect was observed for quiet sleep or indeterminate sleep. On average, the sound level was 51 dBA (range 36–113 dBA) and did not differ significantly among the three periods. The strongest relationship between the minute‐by‐minute maximum sound level and movement actigraphy was observed for the OFF1 condition (ρ0.301, p < 0.001). These findings suggest that DREAMIES® may augment sleep in premature infants by reducing acute episodes of adverse noise in the NICU. [ABSTRACT FROM AUTHOR]

Objective: The advantages of laser stapedotomy are less trauma and more precise and minimally invasive techniques; however, the potential risk of overheating from the laser combined with the endoscope tip must be considered. This study aimed to assess the efficacy and safety of diode lasers for endoscopic stapes surgery. Methods: A retrospective review of 56 patients with otosclerosis who underwent primary endoscopic stapedotomy with a diode laser from 2017 to 2020 was conducted. Demographic data, intraoperative findings, preoperative and postoperative audiological assessments, and postoperative complications were analyzed. Results: There was no statistically significant difference between the preoperative and postoperative bone conduction thresholds. The mean postoperative air‐bone gap (ABG) improved significantly compared to the preoperative ABG (4.07 vs. 35.43 dB, p <.001). The postoperative ABG closure within 10 dB at 6 and 12 months was achieved in 87.50% and 91.07% of patients, respectively. The postoperative pain scores at 4 and 24 h were 2.55 and 0.39, respectively. Immediate postoperative vertigo was reported in 12.50% of patients, with 100% complete recovery 2 months after surgery. The chorda tympani nerve was preserved in all the cases. Postoperative taste disturbances at 2 and 12 months were observed in 17.86% and 1.79% of patients, respectively. Conclusion: The diode laser in endoscopic stapedotomy is a safe and effective technique that provides satisfactory hearing outcomes. Temporary taste disturbances during the early postoperative period are a concern. The handheld diode laser delivery system is suitable for an endoscopic approach and is an alternative armamentarium for the treatment of otosclerosis. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Objectives: The young population requires early rehabilitation of their hearing loss for normal cognitive, auditive hence social development. All of which, in turn, may have an impact on quality of life (QoL). This study aims to evaluate QoL between two different bone conduction (BC) hearing devices: a noninvasive adhesive hearing aid (Adhear [ADH]) vs. an active transcutaneous implant (Bonebridge [BB]). Methods: This study composed of 12 BB and 15 ADH users. Pure tone as well as speech in noise and quiet measurements were evaluated and compared to the Assessment in QoL questionnaire (AQoL‐6d). Results: Freefield results showed significant improvements for both devices compared to the unaided condition (p <.0001). Emphasis needs to be drawn on the different unaided level of conductive hearing loss as well as the indication range for both evaluated device groups: the ADH subjects exhibited a mean BC value of 9.50 ± 7.96 dB HL (the indication range up to 25 dB) and the BB subjects a mean of 23.33 ± 25.66 dB HL (the indication range up to 45 dB). Speech perception in quiet and in noise was significantly improved (p <.05; p <.001, respectively). QoL was significantly improved for both treatments (p <.05) but was not different among the devices, and the values were similar to their normal hearing, age, and sex‐matched control group. High correlations were found between QoL utility scores and improved PTA4 in the aided condition (r2 =.8839 and.7810 for BB and ADH, respectively). Conclusion: Our results show that both devices offer significant beneficial audiological rehabilitations with significantly increased QoL. However, the underlying condition and the unaided degree of hearing loss, hence the required higher stimulation must be the deciding factor when opting for a hearing device, and this should be independent of age. Level of evidence: 2c. [ABSTRACT FROM AUTHOR]

Introduction: Single-sided deafness (SSD) is characterized by hearing loss in one ear (pure tone average - PTA - 70 dB HL and more) with practically normal hearing in the other ear (losses up to 30 dB HL). One of the solutions is cochlear implantation, which, unlike other compensatory mechanisms (CROS system, direct bone conduction systems), is the only one that enables binaural hearing. Material and methods: Six pediatric patients with SSD who underwent cochlear implantation at FN Motol in 2020-2021 were included in the study. We monitored the development of auditory perception with a cochlear implant, the ability of directional hearing and the average daily time of use of the sound processor. Results: All patients use the sound processor regularly, subjectively and objectively their hearing perception improved. Directional hearing is not yet demonstrable. We will continue to monitor the patients and the knowledge gained will need to be verified on a larger set in the future. Conclusion: Cochlear implantation can be a suitable way to solve unilateral deafness in children. When indicating, it is necessary to consider the etiology of the hearing defect, the duration of the deafness, and the motivation of the children and their parents to regularly use the sound processor. [ABSTRACT FROM AUTHOR]

To provide guiding principles to deliver high-quality treatment with implantable bone conducting hearing devices and to guarantee the best possible outcomes for each patient in Belgium. A consensus meeting was convened on March 26, 2019, including surgeons and audiologists from different bone conducting hearing devices hospitals and fitting centers in Belgium, and an independent moderator. First, different care models for treatment with bone conducting hearing devices, currently applied in Belgium, were identified and discussed. It was agreed that bone conducting hearing devices surgery and fitting should be provided by clinicians with adequate training and experience and that bone conducting hearing devices care should be centralized as much as possible. Preferably sound processor fitting is carried out within the bone conducting hearing devices hospital or at a specialized fitting center outside the hospital. In any case, a close interdisciplinary collaboration between both the bone conducting hearing devices surgeon and the bone conducting hearing devices audiologist was considered critical to ensure good patient outcomes (e.g., to facilitate appropriate treatment in the event of complications). Second, general guidelines were debated and agreed upon to improve the quality of care for the different phases of the patient journey (referral, assessment, treatment, and follow-up). Providing a standard of care means that every person, regardless of the type or degree of hearing loss, the region in which they reside and the healthcare professional they see, has access to a standardized assessment and treatment process, resulting in the most efficient hearing solution for his or her indication. This consensus statement was a first step towards a more standardized approach for treatments with bone conducting hearing devices in Belgium. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to verify the accuracy of the web-based audiometer HEARZAP in determining hearing thresholds for both air and bone conduction. Method: Using a cross-sectional validation design, the web-based audiometer was compared to a gold standard audiometer. Participants in the study totaled 50 (100 ears), of which 25 (50 ears) had normal hearing sensitivity and 25 (50 ears) had various types and degrees of hearing loss. All subjects underwent pure tone audiometry, including air and bone conduction thresholds, using the web-based and gold standard audiometers in a random order. A pause between the two tests was allowed if the patient felt comfortable. The testing for the web-based audiometer and gold standard audiometer was done by two different audiologists with similar qualifications in order to eliminate tester bias. Both the procedures were performed in a sound treated room. Results: For air conduction thresholds and bone conduction thresholds, respectively, the mean discrepancies between the web-based audiometer and the gold standard audiometer were 1.22 dB HL (SD = 4.61) and 0.8 dB HL (SD = 4.1). The ICC for air conduction thresholds between the two techniques was 0.94 and for the bone conduction thresholds was 0.91. The Bland Altman plots likewise indicated excellent reliability between the two measurements, with the mean difference between the HEARZAP and the gold standard audiometry falling within the top and lower limits of agreement. Conclusion: The web-based audiometry version of HEARZAP produced precise findings for hearing thresholds that were comparable to those obtained from an established gold standard audiometer. HEARZAP, has the potential to support multi-clinic functionality and enhance service access. [ABSTRACT FROM AUTHOR]

Bone conduction is a promising haptic feedback modality for upper-limb prosthesis users, however, its potential and characteristics as a non-invasive feedback modality have not been thoroughly investigated. This study aimed to establish the temporal and spatial characteristics of non-invasive bone conduction as a sensory feedback interface for upper-limb prostheses. Psychometric human-subject experiments were conducted on three bony landmarks of the elbow, with a vibrotactile transducer affixed to each to provide the stimulus. The study characterized the temporal domain by testing perception threshold and resolution in amplitude and frequency. The spatial domain was evaluated by assessing the ability of subjects to detect the number of simultaneous active stimulation sites. The experiment was conducted with ten able-bodied subjects and compared to two subjects with trans-radial amputation. The psychometric evaluation of the proposed non-invasive bone conduction feedback showed results comparable to invasive methods. The experimental results demonstrated similar amplitude and frequency resolution of the interface for all three stimulation sites for both able-bodied subjects and subjects with trans-radial amputation, highlighting its potential as a non-invasive feedback modality for upper-limb prostheses. [ABSTRACT FROM AUTHOR]

Background There is limited evidence demonstrating the ability of audiometric bone vibrators to elicit ocular vestibular evoked myogenic potentials (oVEMPs). The RadioEar B71 bone vibrator has insufficient power output to reliably evoke oVEMPs, which has previously left nonaudiometric and nonmedically approved devices such as the Brüel & Kjær Mini-shaker 4810 as the only feasible alternative. The newer RadioEar B81 model has a higher power output than its predecessor, but evidence for its suitability for eliciting oVEMPs has so far been mixed. This variability may be due to factors other than simply the power output, such as whether sufficient static force is applied to hold the transducer in place and transfer vibratory energy into the bone. Purpose This study aimed to test the hypothesis that bone-conducted oVEMPs can be obtained with the B81 that are equivalent to those from the Mini-shaker, the de facto gold-standard transducer for this response, when the outputs of the two transducers are matched and they are coupled with sufficient static force. Research Design oVEMPs elicited by both transducers were recorded in a counterbalanced within-groups design. Study Sample Sixteen healthy adults (12 female; 22–47 years) with no history of hearing, balance, or neurological disorders were included in the study. Data collection and analysis One-cycle alternating tone-burst stimuli at 500 Hz were delivered to the mastoid from each transducer. The vibratory force levels were matched at 127 dB peak-to-peak equivalent force levels, and both were held in place with a static force around 10 N. oVEMP waveforms were gathered from the contralateral eye using the belly-tendon montage and were assessed for statistical equivalence. Results There was an absence of any statistically significant difference in N10 and N10–P15 amplitudes in oVEMPs from each transducer. Conclusions Our results indicate that B81 can elicit oVEMPs with no meaningful differences to those from the Mini-shaker, provided effective stimulus levels are matched and static force is sufficient. Although further work is necessary to investigate equivalence at other stimulus frequencies and stimulation sites, the results support the use of the B81 to elicit 500Hz oVEMPs at the mastoid in a clinical setting. [ABSTRACT FROM AUTHOR]

Background: The benefit of hearing rehabilitation is often measured using audiological tests or subjective questionnaires/interviews. It is important to consider both aspects in order to evaluate the overall benefits. Currently, there is no standardized method for reporting combined audiological and patient reported subjective outcome measures in clinical practice. Therefore, this study focuses on showing the patient's audiological, as well as subjective outcomes in one graph using data from an existing study. Method: The present paper illustrated a graph presenting data on four quadrants with audiological and subjective findings. These quadrants represented speech comprehension in quiet (unaided vs. aided) as WRS% at 65 dB SPL, speech recognition in noise (unaided vs. aided) as SRT dB SNR, sound field threshold (unaided vs. aided) as PTA4 in dB HL, wearing time and patient satisfaction questionnaire results. Results: As an example, the HEARRING graph in this paper represented audiological and subjective datasets on a single patient level or a cohort of patients for an active bone conduction hearing implant solution. The graph offered the option to follow the user's performance in time. Conclusion: The HEARRING graph allowed representation of a combination of audiological measures with patient reported outcomes in one single graph, indicating the overall benefit of the intervention. In addition, the correlation and consistency between some results (e.g., aided threshold and aided WRS) can be better visualized. Those users who lacked performance benefits on one or more parameters and called for further insight could be visually identified. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of Neurotec® herbal capsule (100 mg twice a day for 3 months) on the tinnitus symptoms in comparison with the placebo. Design: A double‐blind randomised clinical trial. Setting: Otolaryngology clinic of Baqiyatallah Hospital. Participants: Patients suffering from subjective tinnitus. Main Outcome Measures: Pure tone audiometry was measured at.5, 1, 2, 4 and 6 kHz frequencies before and after the third month of intervention. In addition, Tinnitus Handicap Inventory (THI) questionnaire as well as visual analogue scale (VAS) for tinnitus loudness, daily annoyance, daily life or sleep disturbance, daily perception and mood alteration were evaluated. Results: Finally, 103 (69 males and 34 females) patients with a mean age of 51.33 ± 13.91 years were analysed. In contrast with control group, patients in intervention group showed a remarkable decrease in THI score after 3 months of treatment (p <.05). Although both groups had improvements in VAS scores, mood disturbance, daily tinnitus perception and daily life alteration scores were only improved in the intervention group. The mean pure tone air and bone conduction were not significantly different between the control and the intervention group at baseline and 3 months after the intervention at.5, 1, 2 and 4 kHz (p >.05). Conclusion: A 3‐month treatment with Neurotec capsules in addition to patient education is of benefit for managing symptoms in patients with chronic tinnitus. [ABSTRACT FROM AUTHOR]

Introduction: A nonsurgical bone conduction hearing aid (BCHA) is a well-established treatment for children with congenital unilateral microtia and atresia (UMA). To date, limited studies have evaluated the audiological characteristics of the different wearing modes in the same nonsurgical BCHA.Methods: Eighteen patients with UMA aged 5-24 years were included. Warble tones at frequencies of 0.5, 1, 2, and 4 kHz were presented to determine functional hearing gain (FHG) of hearing thresholds (in dB HL) in the sound field. The speech perception abilities were assessed by the speech discrimination score (SDS, in %) of monosyllables, disyllables, and sentences in quiet and noise using the Chinese Mandarin speech test materials. Hearing outcomes were evaluated with the ADHEAR™ worn on a softband and with an adhesive adapter. A correlational analysis was conducted to analyze the correlations between variables (e.g., age, height, weight, body mass index [BMI], bone conduction pure-tone threshold, and air conduction pure-tone threshold) and the differences in the two wearing modes.Results: The mean FHG (standard deviation, SD) at 0.5-4 kHz was 20.63 (3.94) dB HL with the adhesive adapter and 26.39 (3.15) dB HL with the softband. When aided with the BCHA, significant improvements in SDS were revealed in all Mandarin speech test material lists either in quiet or noise for both wearing modes. Compared with the adapter mode, the softband provided higher aided SDS values. Correctional analyses revealed that higher BMI values were positively associated with larger delta outcomes between the two coupling methods of the softband and adhesive adapter in patients with UMA. Furthermore, a larger delta average FHG of 0.5-4 kHz was consistently associated with larger delta monosyllabic SDS in quiet, disyllabic SDS in quiet, and disyllabic SDS in noise.Discussion: To the best of our knowledge, this is the first study to compare the hearing benefits of coupling methods using novel adhesive adapters and conventional softbands with the same audio processor (ADHEAR™). Under uniform internal settings, softband integration provided more hearing benefits than adhesive adapter integration, and the differences were more obvious in patients with higher BMI values. Besides, a brief measurement of FHG can be utilized to predict individualized speech perception levels. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the possibilities of artefact reduction using different anatomical implant positions with the Bonebridge bone-conduction hearing implant 602 for a patient with an acoustic neuroma requiring regular diagnostic magnetic resonance imaging of the tumour position. Method: Three implant positions and magnetic resonance imaging examinations with and without customised sequences for metal artefact suppression were investigated. The diagnostic usefulness was rated by a radiologist (qualitative evaluation), and the relation between the area of artefact and the total head area was calculated (quantitative evaluation). Results: Following the qualitative analysis, the radiologist rated the superior to middle fossa implant placement significantly better for diagnostic purposes, which is in agreement with the calculated artefact ratio (p < 0.0001). The customised slice-encoding metal artifact correction view-angle tilting metal artifact reduction technique sequences significantly decreased the relative artefact area between 5.13 per cent and 25.02 per cent. The smallest mean artefact diameter was found for the superior to middle fossa position with 6.80 ± 1.30 cm (range: 5.42–9.74 cm; reduction of 18.65 per cent). Conclusion: The application of artefact reduction sequencing and special anatomical implant positioning allows regular magnetic resonance imaging in patients with the bone-conduction hearing implant 602 without sacrificing diagnostic imaging quality for tumour diagnosis. [ABSTRACT FROM AUTHOR]

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Bone-conducted (BC) sounds are mainly presented to the mastoid process of the temporal bone or condyle process of the mandible. However, BCsounds presentation to the face such as the nasal bone has also been investigated. As the face has complex structures of the human body, slight differences in the presentation parts will also change perception and propagation mechanism. To assess the speechperception characteristics, we conducted monosyllable articulation tests in Japanese when BC sounds were presented to facial parts (nasal, infraorbital region, zygomatic, jaw angle, and chin), and compared with air-conducted sounds and conventional parts (mastoid and condyle processes). The results suggest that, at least in the parts investigated in the current study, the intelligibility of the facial parts was about the same as those of the conventional parts. These results indicate that practical speech perception is possible with BC devices using the facial parts. [ABSTRACT FROM AUTHOR]

Bone conduction (BC) is the conduction of sound to the inner ear primarily through biological tissues. BC has been applied to hearing aids, earphones and other audio devices, such as smart glasses, present stimuli to the face. One of the important characteristics of BC is the occlusion effect (OE): a phenomenon whereby low-frequency sounds are perceived as being enhanced when the ear canal is occluded. Studies examining OE in facial parts have revealed that the OE in some facial parts (the nasal bone, infraorbital region, jaw angle) was equal to or better than OE in the conventional parts (the mastoid process and condylar process). In this study, we evaluated effects of OE on speech perception. We investigated the effects of OE on monosyllable articulation in the mastoid process, condylar process, nasal bone, and infraorbital region. The results showed that OE increased articulation and can be applied to facilitating voice communication. [ABSTRACT FROM AUTHOR]

Bone conduction hearing aids are designed to help individuals with conductive hearing loss. However, a common challenge in the use of these devices is the presence of "crosstalk," where sound intended for one ear is received by the opposite ear by bone conduction. In this study, we aimed to address this issue by investigating the potential of canceling crosstalk at an accelerometer on the mastoid. Surprisingly, the cancellation was still noticeable despite being designed to occur at the mastoid. Our test results with normal-hearing individuals showed that their hearing thresholds improved with crosstalk cancellation compared to when crosstalk was not canceled. These results demonstrate the potential for enhancing bone conduction hearing aids using crosstalk cancellation technology. [ABSTRACT FROM AUTHOR]

Background: Cholesteatoma is a collection of keratinized squamous epithelium in middle ear and pneumatic areas of temporal bone. It can be said as an invasive disease which is often associated with sensorineural hearing loss. It is seen that hearing loss varies with the location of disease, duration of disease, and extension of cholesteatoma. Aims and Objectives: The aim of this study is to see the association of cholesteatoma and bone conduction threshold difference as compared to contralateral normal ear. Materials and Methods: This study was done between August 2019 and December 2021 at our tertiary care center. It is a prospective study of 50 patients. Results: In our study, we saw that there is a considerable sensorineural hearing loss associated with cholesteatoma depending on which varies with location and extension. Conclusion: Our study shows that the more extensive the cholesteatoma more is the sensorineural hearing loss.

Introduction: The bone-anchored hearing system has become the most viable treatment option for subjects with conductive or mixed hearing loss, who are unable to benefit from conventional hearing aids or middle ear surgery. Objective: To compare the surgical and audiological outcomes between the minimally-invasive Ponto surgery and a linear incision with soft tissue preservation techniques in bone-anchored hearing system recipients. Methods: A retrospective study was carried out from January 2017 to June 2018. Forty-two adult patients eligible for unilateral bone-anchored hearing system surgery with the Ponto system were included in the study. The implant and abutment lengths used varied from 3 to 4 mm and from 6 to 14 mm, according to the bone and skin thickness of the participants, respectively. Results: Twenty-two surgeries were performed using the minimally invasive Ponto surgery technique (52.4%) and 20 (47.6%) using the linear incision. The mean age of the subjects implanted with minimally invasive Ponto surgery and linear incision techniques were 42.0 and 33.3 years old, respectively. Ten male (45,5%) and 14 (70%) female patients were implanted using minimally invasive Ponto surgery and the linear incision techniques, respectively. There were no differences between pure tone audiometric thresholds and monosyllabic word recognition scores of the subjects, when comparing both surgical techniques. The minimally invasive Ponto surgery technique significantly reduced the surgical time compared to the linear incision technique. There were no differences between both surgical techniques for skin-related complications; (Holgers 3 and 4) which occurred in 18.8% for MIPS and in 25% for linear incision. Subjects included in the minimally invasive Ponto surgery technique group showed a superior cosmetic outcome, with no surgical scar or additional sutures. Conclusion: The surgical and audiological outcomes were satisfactory and were not correlated to the surgical technique selected in all subjects. When compared to the linear incision, the minimally invasive Ponto surgery technique showed reduced surgical time and superior esthetic outcomes in the postoperative follow-up.

This document is a correction notice for an article titled "Long-term data of the new transcutaneous partially implantable bone conduction hearing system Osia®" published in the European Archives of Oto-Rhino-Laryngology. The correction addresses several errors in the original publication, including incorrect sentences and phrases, as well as inaccuracies in figure captions. The corrected information provides accurate data on the improvement of hearing-related quality of life and speech recognition scores in patients with Osia implants. The correction notice emphasizes the largest benefit for patients with over three years of Osia experience and clarifies the outcomes for different patient groups. [Extracted from the article]

This document is a correction notice for an article titled "Long-term data of the new transcutaneous partially implantable bone conduction hearing system Osia®" published in the European Archives of Oto-Rhino-Laryngology. The correction addresses several errors in the original publication, including incorrect sentences and phrases, as well as inaccuracies in figure captions. The corrected information provides accurate data on the improvement of hearing-related quality of life and speech recognition scores in patients with Osia implants. The correction notice emphasizes the largest benefit for patients with over three years of Osia experience and clarifies the outcomes for different patient groups. [Extracted from the article]