Search

Objective: Phone- and tablet-based hearing testing systems are now widely available. Here, we evaluated one such system from TympaHealth by comparing air conduction thresholds and resultant hearing aid targets and output, measured with the TympaHealth system with those measured using standard audiometry. Design: The hearing thresholds of 35 adults were measured using standard audiometry and the TympaHealth system. Each set of thresholds was used to generate NAL-NL2 targets and program a hearing aid. The data from each system were compared. Results: Bland--Altman analyses showed overall mean differences between thresholds measured with each system to be small, with 85% of TympaHealth thresholds being within ±5 dB of the standard audiometric thresholds, although TympaHealth thresholds were higher (poorer) than the standard audiometric thresholds. The hearing aid targets and gains generated from the standard audiometric thresholds were lower (less amplification) than those generated from the TympaHealth thresholds but again, mean differences at each frequency were small and likely imperceptible. Conclusion: These findings support the possibility that valid hearing testing can take place outside of a clinical booth using portable systems like that from TympaHealth, opening up the possibility of testing hearing and fitting hearing aids through pharmacies, opticians, and in care homes. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the short- and long-term effects of a new cognitive sound exposure therapy (CSET) in patients with hyperacusis. Method: A new therapy was developed to reduce hyperacusis using sound exposure combined with breathing and relaxation strategies from both accep- tance and commitment therapy and cognitive behavioral therapy. Patients who were referred to the Speech and Hearing Centers located in Hengelo and Zwolle in the Netherlands and aged ≥ 18 years with hyperacusis as main complaint and no or mild hearing loss were included in this study. Patients were seen for CSET between June 2020 and August 2022. The sessions took place biweekly. Sessions ended when exposure reached a level with a maximum of 70--80 dB SPL. Short-term effects between the start and the end of therapy were based on tolerable level of sound exposure (dB SPL), subjective-level hinderance of hypera- cusis, and sensitivity to sound using the Hyperacusis Questionnaire (HQ). The long-term effect was based on HQ 6 months after the end of therapy. Linear mixed-effects and regression models were applied to study outcomes over time. Results: In total, 30 patients, 15 men and 15 women, aged between 24 and 76 years were included in this study. The mean number of sessions during ther- apy was 6 and ranged between 4 and 8. Results showed an increase of exposure level (mean change was +23.7 dB with an SD of 7.9, p< .001), a decrease in sensitivity to daily sounds (mean [SD] change was -1.6 [2.1], p<.001),anda decrease in HQ (mean [SD] change was -9.8 [4.9], p< .001), between the start and the end of therapy. There was no significant change in HQ after the end of therapy and 6 months later; mean (SD) change was 0.2 (4.3), p=.81. Conclusions: The evaluation of CSET indicated a decrease in short- and long- term sensitivity to sound in patients with hyperacusis. Additionally, CSET has shown a positive impact, not only for the sounds used in the therapy sessions but also in transferring benefits to everyday sounds. The results of combining psychoeducation, sound exposure, and counseling are promising and warrant further evaluation. [ABSTRACT FROM AUTHOR]

Firefighter hoods must provide protection from elevated temperatures and products of combustion while simultaneously being comfortable and limiting interference with firefighting movement or completion of fireground activities. This study was to quantify the impact of hood design (traditional knit hood vs. several models of particulate-blocking hoods) on wearability measures such as range of motion, noise production and hearing threshold. Firefighters' perceptions of wearability were also collected. In a controlled laboratory environment, 24 firefighters performed movement and hearing tests. Wearing particulate-blocking hoods resulted in decreased rotational range of motion, and thicker hoods reduced hearing ability. Design, but not necessarily the number of layers, affected noise production by the hood during head movement. Practitioner summary: Particulate-blocking hoods resulted in reduced rotational range of motion relative to the traditional design and the no-hood condition. Hoods with additional layers resulted in decreased hearing ability. Noise production was increased in designs of particulate-blocking hoods with a membrane-based blocking layer independent of the number of layers. [ABSTRACT FROM AUTHOR]

Purpose: This study explores the relationship between sensorineural hearing loss (SNHL) in mid-life adults and cognitive function, focusing on executive functions. Given the projected rise in dementia cases, identifying modifiable risk factors for cognitive decline is imperative. SNHL has emerged as a potential risk factor, with hearing loss accounting for a substantial portion of dementia cases. However, the cognitive implications of SNHL in mid-life adults are not well understood. Method: The study examined 50 participants, 25 with bilateral unaided mild SNHL (AHL) and 25 with normal hearing (ANH). A battery of audiological assessments and cognitive tests, including the Trail Making Test (TMT), was administered. TMT measures included direct scores (completion time and errors) and derived scores (difference, ratio, proportion, sum, and multiplication scores). Results: The AHL group displayed significantly poorer peripheral hearing compared to the ANH group, as reflected in pure-tone audiometry, speech reception thresholds, and speech identification scores. Significant differences were observed in all direct and derived TMT measures except for the ratio and proportion scores. This suggests that while overall cognitive disturbances were evident in the AHL group, they were not exclusive to executive function deficits. Notably, we did not identify any statistically significant effects of hypertension, diabetes, smoking, alcohol consumption, or physical activity on TMT scores. Conclusion: This study highlights the potential impact of SNHL on cognitive function in mid-life adults. Mid-life SNHL is associated with cognitive differences, emphasizing its role as a modifiable risk factor for future cognitive decline. This research underlines the need for further investigation into the cognitive effects of aided hearing and a multidisciplinary approach to understanding these alterations in cognitive function. [ABSTRACT FROM AUTHOR]

This study evaluated the diagnostic performances of a tablet-based hearing screening test by assisted-test and self-test modes. Measurements were performed with the SoTone tests in normal hearing and hearing-impaired adult participants using an Android tablet and calibrated Bluetooth headphones. The duration of assisted- and self-test modes were compared. Receiver operating characteristic (ROC) curves were plotted after calculations of sensitivity and specificity at 20, 30, and 35 dB HL cut-off values. 217 participants performed the tests. The effect of test mode (assisted versus self) was compared in a sample of 103 participants. Self-test duration (89 s) was significantly longer than the assisted-test duration (75 s) (p = 0.003, Wilcoxon test). For the 20, 30, and 35 dB HL cut-off values, sensitivity was between 92% and 96%, and specificity was between 79 and 90%. Concordance of results between assisted-test and self-test modes was excellent (Cohen's kappa = 0.81, p < 0.001). The SoTone hearing screening test is accurate for identifying the presence of a suspected hearing loss at 20 dB HL or more in adults. It can be used either in assisted-test or self-test modes. [ABSTRACT FROM AUTHOR]

In automated hearing threshold determination procedures, prespecified response- time limits can be applied to evaluate whether a stimulus was truly heard by checking whether the test subject reacts to the onset and the offset of the stimuli within given time intervals. The influence of different response-time limits on the threshold of normal-hearing test subjects was investigated. Two-stage hearing threshold level measurements applying the ISO 8253-1 (2010) bracketing procedure were performed. Pre-tests at 125 Hz and 1000 Hz were carried out with maximum accepted response times of 600 ms, 1000 ms, and 1200 ms. Subsequently, thresholds were measured at the seven octaves between 125 Hz and 8000 Hz with maximum accepted response times of 600 ms and 1000 ms. 15 test subjects in pre-tests, 25 test subjects in the main study. Threshold levels determined with a maximum accepted response time of 1000 ms are 2.6 dB lower than those obtained with a maximum accepted response time of 600 ms (95% CI −1.6 dB to 6.9 dB). The threshold shift was similar at all frequencies. Based on this study, response-time limits after both stimulus onset and offset of at least 1000 ms are recommended. [ABSTRACT FROM AUTHOR]

Sensorineural hearing loss is a well-known complication of Streptococcus pneumoniae meningitis. Given the propensity for fibrosis and ossification of the cochlea in bacterial meningitis, implantation must be performed in a timely fashion because a delayed attempt at implantation can frustrate obtaining an optimal technical result or lead to an inability to implant. Obtaining optimal audiometric outcomes is reliant on early hearing screening in patients with streptococcal meningitis. In the absence of standardized protocols, audiometric testing is often overlooked or delayed in the workup and management of meningitis. Our institution implemented a meningitis protocol with a particular focus on timing of audiometric testing in patients with meningitis. We present a patient diagnosed with streptococcal meningitis in the first week of life. Early hearing screening allowed the diagnosis of profound unilateral sensorineural hearing loss and subsequent cochlear implantation at 10 weeks of age, the youngest described in the medical literature. Despite early implantation, there was cochlear fibrosis at the time of implantation. Fortunately, the majority of electrodes were implanted to achieve a serviceable hearing outcome. Serial magnetic resonance imaging scans were obtained because of her contralateral ventriculoperitoneal shunt that allowed unique visualization of the progression of cochlear fibrosis over time. This case demonstrates the importance of including audiometric testing in a standardized meningitis protocol to diagnose hearing loss in a timely and accurate way and to achieve optimal long-term hearing outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This article describes DigiSpan, a new computer-controlled auditory test of forward and reverse digit span, designed to be administered by clinicians, and presents normative and test-retest reliability data for adults. Method: DigiSpan mimics conventional live-voice tests in that it commences with trials that ascend in length until a stopping criterion is met, giving rise to a conventional scaled score. It then administers five additional adaptive trials, the length of which depends on the correctness of the response to the previous trial. Each of these two segments of the measurement gives rise to a scaled score. The ascending and adaptive scores are averaged to give an overall score and subtracted to produce an internal measure of consistency, and hence reliability. Young adults with an Mage of 25 years (N = 163) were tested, of whom 65 were retested on a separate day. Results: The scaled scores from the conventional ascending trials were highly consistent with existing normative data based on live-voice tests. Combination of the conventional scaled score with a scaled score based on the adaptive trials led to 44% reduction in error variance for forward memory span and 20% reduction for reverse memory span. The average of these (32%) is similar to but (insignificantly) less than the 42% reduction in error variance that can be predicted based on adding the five adaptive trials. Conclusions: Replacing live-voice production of digits by a clinician with recorded, computer-controlled production has not affected the difficulty of the test. Adding five additional trials around the sequence length that a test participant can just remember has produced a decrease in measurement error. In addition, the availability of separate scaled scores for the ascending and adaptive phases enables the reliability of the combined score to be checked, for both forward and reverse measurements. The combination of standardized delivery, increased accuracy, internal reliability check, and fast automated scoring makes the test highly suitable for clinical use. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a persistent inflammatory condition affecting the central nervous system, often associated with cognitive impairment. This impairment frequently presents itself as deficiencies in short-term memory, attention, and information processing speed. This research was designed to investigate P300 in patients with MS and its correlation with their cognitive function and their state of fatigue and depression. This work included two groups: the control group (20 subjects) and the study group (30 MS patients). Evaluation encompassed clinical history, audiological assessment, the Expanded Disability Status Scale (EDSS), the fatigue severity scale, the Beck Depression Inventory, Addenbrooke's cognitive examination, and P300 component of event-related potentials (ERPs). Results: The study group exhibited varying degrees of fatigue and depression. The scores of Addenbrooke's cognitive evaluation were reduced in the MS group. The MS group exhibited a considerably prolonged P300 latency compared to the control group. Conclusion: This study demonstrates the effectiveness of P300 in assessing cognitive function in persons diagnosed with MS. [ABSTRACT FROM AUTHOR]

To determine the reliability and validity of the Quick Repeat-Recall Test (Q-RRT). Within-subject repeated measures. Participants completed the Q-RRT at a speech level of 75 dB SPL in 2 noise configurations at signal-to-noise ratios of 5, 10, and 15 dB in a counterbalanced order, along with the full-RRT. The Q-RRT was repeated after 1–3 weeks to estimate within-session and between-session reliability. Participants also completed external validation measures relating speech-in-noise ability (Hearing-In-Noise Test, HINT), memory (Reading Span Test, RST; Forward Digit Span Test, DST-F), and noise acceptance (Tracking of Noise Tolerance, TNT). Twenty-five normal-hearing listeners (mean age = 63.9 years). Group Repeat and Recall scores were similar between the full-RRT and the Q-RRT. However, Listening Effort and Tolerable Time ratings were significantly poorer for the full-RRT than the Q-RRT. The average repeat scores correlated with the HINT scores, while the recall scores correlated with the DST-F and RST scores. Tolerable Time ratings also correlated with the TNT scores. Within-session and between-session test-retest reliability using intraclass correlation coefficients were fair-to-excellent (0.41–0.91) depending on the outcome measures. The Q-RRT is a reliable and valid measure of speech-in-noise ability, working memory, listening effort, and noise acceptance. [ABSTRACT FROM AUTHOR]

The aim of the research was to evaluate the feasibility of measuring the bone conduction hearing threshold using self-administered mobile audiometry. A single-centre, closed, cross-over trial was carried out on patients from the ENT Department. A mobile-based, self-administered, audiologist-assisted assessment of the bone conduction hearing threshold was carried out by means of the open-access, freeware app Hearing Test using two types of bone conduction headphones: professional B71 bone transducer and commercially available AfterShokz Openmove open-ear headphones. Seventy-seven ears. A test-retest examination revealed the lowest standard deviation for open-ear headphones at 3.33 dB (95% CI 2.92–3.79). When compared with pure tone audiometry, the intraclass correlations of 0.95 (95% CI 0.94–0.96) and 0.90 (95% CI 0.88–0.92) were obtained for the bone transducer and for the open-ear headphones, indicating excellent and good reliability, respectively. However, the regression slope of 0.67 was found for the air-bone gap when using open ear headphones, which was significantly different from 1 (p < 0.001). Open-ear headphones provide an alternative for estimating bone conduction once the air-bone gap has been adjusted by a factor of 1/0.6 7 ≅1.5. They demonstrate improved reproducibility over the bone transducer and are much easier to use with a mobile device. Trial Registration: Wroclaw Medical University, Science Support Centre, BW60/2020 [ABSTRACT FROM AUTHOR]

Consumer-grade insert earphones (IEs) can be utilised for audiometry, but their calibration values and threshold reliability may differ from the audiometric IE. This study measured the equivalent threshold sound pressure levels (ETSPLs), and the test-retest threshold variation when a consumer IE (Sennheiser CX100) was fitted with: (1) silicone stock ear tips that came along with the earphone, (2) replacement foam ear tips (KZ acoustics) and (3) silicone otoacoustic emission (OAE) probe ear tips. Study 1 determined ETSPL values in 25 normal-hearing subjects aged 18–25 years at seven test frequencies (500–8000 Hz). Study 2 assessed the intra- and inter-session test-retest threshold reliability in a separate group of 50 adult subjects. The ETSPL values for the consumer IE deviated from the reference values for audiometric IEs, with the largest differences (7–9 dB) observed at 500 Hz across ear tips. This is likely related to shallow tip insertions. However, test-retest threshold variations were comparable to those reported for audiometric transducers. Ear tip-specific corrections to the reference thresholds in the standards are required for calibration of consumer IEs used in low-cost audiometry when their ear tips only allow superficial insertion into the ear canal. [ABSTRACT FROM AUTHOR]

Background and Aim: The Acceptable Noise Level (ANL), which is an effective clinical tool for quantitative assessment of noise tolerance, is affected by some known variables related to both subject and testing materials. The present study examined how the characteristics of different babble noises may affect the ANL results in normal adult listeners. Methods: Forty Persian listeners with normal hearing participated. In addition to typical ANL testing with 12-talker noise, the ANL was obtained in 8 different conditions varying in number of talkers from 2 to 10 in the babble noises presenting forward and backward. Results: There was a significantly lower ANL for 2-talker babble compared to 4, 8, 10, and 12-talker babble in both forward and backward noise conditions. With the increase in talkers in noise, the ANL becomes worse but reaches almost a plateau with more than 4 talkers in babble noise. There was a statistically significant difference between 2-talker forward and 2-talker backward noises, with no difference for the other conditions. Conclusion: This finding that the ANL is affected by the number of talkers in babble noise and by the forward and backward background noise suggests that informational masking and listening in dip mechanisms are involved in ANL for normal hearing people at least. [ABSTRACT FROM AUTHOR]

Background and Aim: The utilization of speech materials in audiological assessments has faced challenges due to a lack of standardization and insufficient consideration of acoustic factors. This study aimed to develop a set of psychometrically validated monosyllabic and disyllabic words in Persian for use in auditory tests. Methods: This cross-sectional study involved collecting the most frequently used one- and two-syllable words from Persian dictionaries. A panel of experts evaluated the selected words using a 4-point Likert scale. Based on their recommendations, 382 monosyllabic words and 150 disyllabic words met the established criteria. Male and female talkers recorded these words, which were then presented in a random order to 30 young adults with normal hearing (aged 18–30 years). The presentation intensity levels ranged from 0 to 48 dB HL with 8 dB increments. Logistic regression was used to determine the psychometric properties of the words. Results: As the intensity level increased, the percentage of word recognition scores also increased, reaching 100% at an intensity level of 48 dB HL. For Persian monosyllabic words, the mean psychometric slope was 0.29 %/dB for male talkers and 0.25 %/dB for female talkers. The corresponding slopes for Persian disyllabic words were 0.23 %/dB and 0.21 %/dB, respectively. Conclusion: This study successfully developed 382 monosyllabic words and 150 disyllabic words in Persian with comparable psychometric properties. These words can be utilized in auditory tests for Iranian adults. [ABSTRACT FROM AUTHOR]

Purpose: Diminished basal cochlear function, as indicated by elevated hearing thresholds in the extended high frequencies (EHFs), has been associated with lower levels of click-evoked and distortion-product otoacoustic emissions measured at lower frequencies. However, stimulus-frequency otoacoustic emissions (SFOAEs) at low-probe levels are reflection-source emissions that do not share the same generation mechanism as distortion-source emissions. The primary objective of the present study was to examine the influence of hearing thresholds in the EHFs on SFOAEs measured at lower frequencies. Method: SFOAEs were recorded from both ears in 45 individuals with normal hearing thresholds in the conventional audiometric frequencies (0.25–8 kHz). Hearing thresholds were also measured at EHFs (10, 12.5, and 16 kHz). SFOAE magnitudes and signal-to-noise ratios (SNRs) were averaged across 1, 2, and 4 kHz probe frequencies and also averaged for high-probe frequencies (2 and 4 kHz). Results: SFOAE magnitudes and SNRs were significantly higher for ears with better EHF hearing relative to poorer EHF hearing, categorized based on the median split. In addition, hearing in the EHFs significantly contributed to the variance in all SFOAE measures, except for the high-frequency SFOAE magnitudes model. However, hearing thresholds at the probe frequencies did not significantly contribute to the variance in SFOAEs. Conclusions: The study findings suggest that alterations in the basal cochlea, as revealed by EHF hearing thresholds, could be associated with diminished cochlear functioning in relatively apical regions, shown by SFOAEs at lower frequencies, in individuals with normal audiograms. These findings underscore the significance of considering EHF thresholds in audiological evaluations, as alterations in these frequencies may reflect broader cochlear health status. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to inform the revision of a targeted surveillance risk registry by identifying which risk factors predict postnatally identified hearing loss (PNIHL) in children who pass newborn hearing screening and to determine whether hearing surveillance beyond the age of 1 year is warranted. Method: We used retrospective analysis of the audiological outcomes of children born in the state of Queensland, Australia, between January 1, 2010, and December 31, 2019, who passed the newborn hearing screen with risk factors. Results: Approximately one third of children were lost to follow-up and could not be included in the analysis. Risk factors that predicted PNIHL in the analyzed cohort were as follows: syndromes associated with hearing loss, craniofacial anomalies, perinatal infections, and family history of permanent childhood hearing loss. Severe asphyxia did not predict PNIHL but yielded some cases of significant bilateral hearing loss. Hearing loss in children with a history of prolonged ventilation was mild and/or unilateral in nature (except in cases where the hearing loss was due to an unrelated etiology). There were no cases of PNIHL in children with hyperbilirubinemia or neonatal bacterial meningitis. For the risk factors that predicted PNIHL, nearly all hearing losses were detected by 1 year of age, except for children with family history where one quarter of hearing losses had a later onset. Conclusions: The four risk factors recommended for efficient postnatal identification of hearing loss are as follows: syndromes associated with hearing loss, craniofacial anomalies, perinatal infection, and family history of permanent childhood hearing loss. Hearing surveillance through to 1 year old is sufficient except for children with a family history, where a second phase assessment is indicated. Alternative targeted surveillance protocols and models of care are required to minimize loss to follow-up. [ABSTRACT FROM AUTHOR]

Physicians will frequently encounter patients who report tinnitus. Tinnitus is a symptom whereby there is the perception of sound or sounds in the ear or head in the absence of an external source of sound. Most individuals experiencing tinnitus will have a neutral reaction to the percept, but in a small proportion of patients, tinnitus can be a debilitating symptom. When it causes burden, patients can be affected in multiple different facets of life, including impairment in sleep, hearing cognition and psychological and psychiatric well‐being, often resulting in high healthcare utilisation and societal costs. Hence, chronic, disabling tinnitus is a complex condition with multifactorial causes and multiple perpetuating biopsychosocial factors. Despite efforts to increase knowledge about its pathophysiology and research into treatments, little impact on real‐world clinical practice has been seen. There are no proven effective pharmacological treatments or complementary medicines specifically for chronic, disabling tinnitus. Despite this, there is a role for treating this condition through a multidisciplinary approach specifically targeting comorbid active psychiatric conditions, using hearing aids in appropriate clinical settings such as in those with a coassociated confirmed hearing loss, and specialised cognitive behavioural therapy for patients reporting bothersome tinnitus. Cognitive behavioural therapy remains the most valuable evidence‐based intervention in this regard. This narrative review attempts to summarise the current understanding in terms of pathophysiology, assessment and treatment of tinnitus for the internal physician who may encounter patients with disabling, chronic tinnitus. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to compare auditory brainstem response (ABR) findings of normal-hearing preschool children with different types of speech and language pathology. Methods: This retrospective, non-randomized, cohort study was conducted at a tertiary speech and hearing rehabilitation institution according to STROBE guidelines. The study enrolled 123 preschool children diagnosed with speech language pathology and normal hearing. The participants included children with developmental language disorder, autism spectrum disorder, isolated articulation pathology, organic brain lesions, cognitive delay, and a group of very young children with clinically significant speech development delay. All patients underwent standard ABR procedures. Results: The latencies were the longest in the group of children with organic lesion, followed by the group of children with autism spectrum disorder, then the group with developmental language disorder, and the young children group. In the group of children with articulation pathology and the cognitive delay group, the latencies were the shortest. Conclusion: This study showed a connection between several groups of children with language pathology that includes comprehension problems and prolongation of ABR latencies. [ABSTRACT FROM AUTHOR]

Background: The word-in-noise discrimination test evaluates the phonological aspect of speech based on the detection of the vowels. While word-in-noise perception (WINP) test is one of the speech perception exams and evaluates the ability to understand the meaning of words by discovering the consonants. Until now, all word-in-noise tests have assessed speech discrimination performance, and for the first time, the normal values of the WINP test for adults have been determined. Since the normal values of WINP scores in children have not been reported, our research aimed to determine the normal values of the WINP test in children aged 5 to 13 years. In this cross-sectional study, 120 Persian speaking Iranain children with normal hearing thresholds were evaluated from the beginning to the end of spring 2023. We divided them into 4 age groups (A = 5–7 < years, B = 7–9 < years, C = 9–11 < years, D = 11–13 < years). The evaluations included general audiology tests and WINP tests using homtonic-monosyllabic words (HMWs) at a signal-to-noise ratio of 5 dB. Results: Significant difference was observed between the mean scores of the WINP test in age group A (54%) compared to age group B (66%), (Pv = 0.04). Also, the differences between the mean scores of age group A compared to age groups C (70%) and D (69%) were significant (Pv = 0.01, Pv = 0.03). Conclusions: This article presented the norm values of WINP test scores for Persian speaking Iranian children aged 5 to 13 years. The norm values of WINP test scores in the age group of 5–7 years were lower than in the age groups of 7–13 years. The biggest change in the performance of speech perception in noise was observed in the age range of 7–9 years. [ABSTRACT FROM AUTHOR]

To investigate the extent to which Headphone Accommodations in Apple AirPods Pro attend to the hearing needs of individuals with normal audiograms who experience hearing difficulties in noisy environments. Single-arm interventional study using acoustic measures, speech-in-noise laboratory testing, and real-world measures via questionnaires and ecological momentary assessment. Seventeen normal-hearing individuals (9 female, 21–59 years) with self-reported hearing-in-noise difficulties. Acoustic measures showed that, relative to unaided, AirPods Pro provided a SNR advantage of +5.4 dB. Speech intelligibility performance in laboratory testing increased 11.8% with AirPods Pro, relative to unaided. On average, participants trialling AirPods Pro in real-world noisy venues reported that their overall hearing experience was a bit better than without them. Five participants (29%) reported that they would continue using AirPods Pro in the future. The most relevant barriers that would discourage their future use were limited hearing benefit, discomfort, and stigma. Occasional use of AirPods Pro may help some individuals with normal audiograms ameliorate their speech-in-noise hearing difficulties. The identified barriers may inspire the development of new technological solutions aimed at providing an optimal management strategy for the hearing difficulties of this segment of the population. [ABSTRACT FROM AUTHOR]

Background: Patients presenting to the emergency department with acute vertigo pose a diagnostic challenge. While 'benign' peripheral vestibulopathy is the most common cause, the possibility of a posterior circulation stroke is paradoxically the most feared and missed diagnosis in the emergency department. Objectives: This review will attempt to cover the significant advances in the ability to diagnose acute vertigo that have occurred in the last two decades. The review discusses the role of neurological examinations, imaging and specific oculomotor examinations. The review then discusses the relative attributes of the Head Impulse-Nystagmus-Test of Skew plus hearing ('HINTS+') examination, the timing, triggers and targeted bedside eye examinations ('TiTrATE'), the associated symptoms, timing and triggers, examination signs and testing ('ATTEST') algorithm, and the spontaneous nystagmus, direction, head impulse testing and standing ('STANDING') algorithm. The most recent technological advancements in video-oculography guided care are discussed, as well as other potential advances for clinicians to look out for. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the peripheral-to-central auditory systems of people with coronavirus disease 2019 to a well-matched control group and examine the long-term effects of coronavirus disease 2019 on the auditory system. Method: Participants who were outpatients of coronavirus disease 2019 (n = 30) were compared with a well-matched control group (n = 30). Behavioural and electrophysiological tests were performed, and tests were repeated at six months in the coronavirus disease 2019 group. Results: Statistically significant differences were observed in the right ear at 10 kHz (p = 0.007) and 12.5 kHz (p = 0.028), and in the left ear at 10 kHz (p = 0.040) and 12.5 kHz (p = 0.040) between groups. The groups had no difference regarding the other audiological test results (p > 0.05). Conclusion: Extended high-frequency thresholds were affected in the coronavirus disease 2019 patients. No other findings indicated that the peripheral-to-central auditory system was affected. The effect on extended high-frequency thresholds appeared permanent, but no clinically significant new, late-onset auditory system effects were observed. [ABSTRACT FROM AUTHOR]

Purpose: The decision to proceed with bone-conduction hearing devices is not an easy one despite being the audiological management of choice for the majority of children with unilateral hearing loss secondary to microtia--atresia, and the outcome is not always as hoped for. This study aimed to explore parent and child views on decision making and outcomes. Method: Qualitative methods (focus groups and individual interviews) were used to explore parent and child opinions on factors influencing the decision to try a bone-conduction device and their subsequent use or nonuse. Quantitative methods (questionnaires) investigated the impact of hearing loss on listening effort and fatigue, quality of life, and learning, including executive functions such as working memory, information processing, and attention. Twelve parent--child dyads participated in the study, with children aged 9-14 years. Results: A thematic analysis of qualitative data highlighted the importance to parents of timely, consistent, and accessible device information as well as concerns regarding bullying, psychosocial well-being, and educational impacts. Children's concerns included feeling different from their peers, bullying, device appearance, and sound quality, as well as the support they wanted and received. Questionnaire results provided useful confirmatory information on the impacts of unilateral hearing loss on learning for a substantial proportion of the children in this sample. Conclusion: The findings provide insights into the wide range of issues that have implications for the provision of audiological services as well as educational and psychological support for children with unilateral microtia--atresia. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate which of the available Spanish sentence tests U.S. audiologists currently utilize to evaluate Spanish-speaking cochlear implant candidates. An online questionnaire was created and distributed nationwide. A total of 25 audiologists reported using the Spanish HINT and Spanish AzBio. Limitations regarding scoring and variability of accents were described. [ABSTRACT FROM AUTHOR]

Purpose: We studied the role of gender in metacognition of voice emotion recognition ability (ERA), reflected by self-rated confidence (SRC). To this end, we guided our study in two approaches: first, by examining the role of gender in voice ERA and SRC independently and second, by looking for gender effects on the ERA association with SRC. Method: We asked 100 participants (50 men, 50 women) to interpret a set of vocal expressions portrayed by 30 actors (16 men, 14 women) as defined by their emotional meaning. Targets were 180 repetitive lexical sentences articulated in congruent emotional voices (anger, sadness, surprise, happiness, fear) and neutral expressions. Trial by trial, the participants were assigned retrospective SRC based on their emotional recognition performance. Results: A binomial generalized linear mixed model (GLMM) estimating ERA accuracy revealed a significant gender effect, with women encoders (speakers) yielding higher accuracy levels than men. There was no significant effect of the decoder’s (listener’s) gender. A second GLMM estimating SRC found a significant effect of encoder and decoder genders, with women outperforming men. Gamma correlations were significantly greater than zero for women and men decoders. Conclusions: In spite of varying interpretations of gender in each independent rating (ERA and SRC), our results suggest that both men and women decoders were accurate in their metacognition regarding voice emotion recognition. Further research is needed to study how individuals of both genders use metacognitive knowledge in their emotional recognition and whether and how such knowledge contributes to effective social communication. [ABSTRACT FROM AUTHOR]

In this chapter you will be introduced to the hearing aid test box equipment and work through how to prepare the equipment so that it is ready to provide the testing you will use to evaluate, fit, and troubleshoot hearing aids and other amplifiers. At the end of this chapter, you will be familiar with terminology associated with hearing aid test box measures and the leveling required with the reference microphone and coupler microphone to ensure that your measurements are accurate and can be interpreted. [ABSTRACT FROM AUTHOR]

If there is sound in the ear canal, you can measure it with a probe microphone in the ear. The following are a few examples of how you might use your real-ear probe microphone measures beyond verifying hearing aid fittings, signal processing, and function of features. A process to simulate hearing loss to educate and support family members and patients is described. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had a substantial impact on many aspects of human health. There has been a major influence on cognitive capacities, including memory, attention, and cognitive skills for planning, organizing, and solving problems. Furthermore, it appears that the effects of COVID-19 may also impact the auditory system. Objective: To determine the effect of SARS-CoV-2 virus on both hearing and cognitive. Patients and methods: Eighty participants, ranging in age from 20 to 59, will be evaluated for their auditory and cognitive abilities using the following methods: ABR using a click stimulus presented at 90 dBnHL at a rate of 21.1 c/s, followed by a rate of 71.1 c/s; cortical auditory evoked potential (P300) using a tone burst stimulus (50 ms) that will produce an oddball paradigm; measurements of the waveforms' amplitude and latency will be made. Results: ABR recording for both ears showed significant difference between cases and controls as regarding absolute latencies of wave I, III, V, wave V (high rate), amplitude (low and high rates), amplitude ratio, and interaural latency differences (III, I-III, I-V), while P300 outcomes showed a statistically significant difference between cases and controls regarding P300 latency (p < 0.05), while for amplitude, a highly significant difference was found. Conclusion: COVID-19 can harm both the inner ear and the auditory pathway, and it has long-lasting effects on the auditory system and on cognitive processing and attention. [ABSTRACT FROM AUTHOR]

Negativity bias is a cognitive bias that results in negative events being perceptually more salient than positive ones. For hearing care, this means that hearing aid benefits can potentially be overshadowed by adverse experiences. Research has shown that sustaining focus on positive experiences has the potential to mitigate negativity bias. The purpose of the current study was to investigate whether a positive focus (PF) intervention can improve speech-in-noise abilities for experienced hearing aid users. Thirty participants were randomly allocated to a control or PF group (N = 2 × 15). Prior to hearing aid fitting, all participants filled out the short form of the Speech, Spatial and Qualities of Hearing scale (SSQ12) based on their own hearing aids. At the first visit, they were fitted with study hearing aids, and speech-in-noise testing was performed. Both groups then wore the study hearing aids for two weeks and sent daily text messages reporting hours of hearing aid use to an experimenter. In addition, the PF group was instructed to focus on positive listening experiences and to also report them in the daily text messages. After the 2-week trial, all participants filled out the SSQ12 questionnaire based on the study hearing aids and completed the speech-in-noise testing again. Speech-in-noise performance and SSQ12 Qualities score were improved for the PF group but not for the control group. This finding indicates that the PF intervention can improve subjective and objective hearing aid benefits. [ABSTRACT FROM AUTHOR]

Previous work has found that individuals with aphasia demonstrate impaired performance, relative to controls, on listening tasks where target speech is masked by other intelligible speech (Villard & Kidd, 2019). While this deficit may be due in part to impaired cognitive skills (e.g., attention, memory), the current study examined whether impaired linguistic-semantic processing could be a contributing factor as well. This study compared the effect of semantic relatedness between target and masker words on performance on a speech-on-speech masking task, in listeners with aphasia vs. age-matched controls. Additionally, the study compared performance on a remote vs. an in-lab version of the experiment, with the goal of establishing the validity of remote listening experiments in these populations. Eight persons with aphasia (PWA) and eight age-matched controls (AMC) participated in the remote version of the experiment; similarly, eight PWA and eight AMC participated in the in-lab version of the experiment. In both versions, participants listened to short target sentences while ignoring maskers. Maskers consisted of either intelligible speech from the same semantic category as the target (e.g., target and maskers were all fruits), intelligible speech from a distant semantic category from the target (e.g., target was a fruit; maskers were articles of clothing), or speech-shaped, speech envelope-modulated noise. Procedures and stimuli were kept as similar as possible between the remote and in-lab versions of the experiment. In-lab results revealed a significant effect of group, such that PWA performed more poorly than AMC, as well as a significant effect of masking condition, such that participants performed more poorly on speech masking vs. noise masking conditions. No significant differences between same-category and different-category maskers were observed. A comparison of remote vs. in-lab results revealed similar patterns of performance between the two settings but suggested that remote testing resulted in overall noisier data. These findings add to the existing body of knowledge about auditory masking in aphasia. Furthermore, they help lead to a clearer understanding of barriers to social engagement and community participation in PWA by characterizing challenges associated with communicating in noisy settings. The study also provided qualified support for the use of remote testing paradigms for listening experiments. [ABSTRACT FROM AUTHOR]

Background and Aim: Speech is a vital stimulus and the ultimate goal of hearing aid fitting to make the speech an audible signal. The purpose of this research was to investigate whether it is possible to track the threshold with speech phonemes and which of the two fitting methods of Desired Sensation Level version 5.0 (DSL v5.0) and National Acoustic Laboratories-Nonlinear 2 (NAL-NL2) provide better audibility for the phonemes. Methods: In this cross-sectional study, the unaided thresholds of 18 normal-hearing children and the aided thresholds of 15 hearing-impaired children aged 5-8 years were evaluated with two types of stimuli. DSL v5.0 and NAL-NL2 methods were used for hearing aid fitting in hearing-impaired children. Results: There was a significant relationship between the unaided and aided thresholds of each phoneme and the warble tone threshold at the corresponding frequency (p<0.01), except for the phoneme/s/. The results showed a significant difference between the aided thresholds of each phoneme and the upper limit of the speech banana in the corresponding frequency for each method (Z=-4.99, p≤0.001). Conclusion: The results showed that phonemes could be used to assess unaided and aided thresholds. In the first fit, both methods estimated the amount of amplification that caused the average aided thresholds for these six phonemes for moderate to severe hearing loss to be positioned within the speech banana range, except for the average aided thresholds for the/s/phoneme in the NAL-NL2 method that was placed outside the range. [ABSTRACT FROM AUTHOR]

Background: Occupational noise is considered a factor contributing to acquired hearing loss (HL) in adults. Frequent noise exposure can cause cochlear damage, leading to sensorineural HL, tinnitus, vertigo, and other non auditory effects as well. Although it is well known that liquefied petroleum gas (LPG) plants in India have become a workplace source for occupational noise pollution exposure, there are not many studies that probe into the auditory effects of workplace noise in LPG plants. Aim: The study aims to document HL and self reported otological symptoms in employees with occupational noise exposure at a typical LPG plant in a suburban location in India. 53 employees who reported workplace noise exposure were assessed for HL and self reported auditory symptoms. Method: Self reported symptoms were collected using a custom made case history questionnaire, and auditory sensitivity was measured using air conduction audiometers. Results: Among the 53 participants, 27 tested positive for HL. A mild degree of HL was frequently observed, followed by a moderate and severe degree of HL. In the self reported otological complaints reported by 31 participants, HL and aural fullness were the most commonly reported auditory symptoms. Additionally, the use of ear protection devices and hearing conservation practices among the participants were poor. Conclusion: Hearing loss and self-reported auditory symptoms were present in the study group indicating the effect of occupational noise in the auditory system. [ABSTRACT FROM AUTHOR]

Background: Exploratory tympanotomy in cases of traumatic ossicular disruption with intact tympanic membrane is crucial for both diagnostic and therapeutic purposes. Performing this procedure using the endoscope is gaining popularity. Hence, this study aimed to demonstrate varieties of ossicular pathology and their management in our institution. Methods: A retrospective evaluation was conducted of 136 ears in patients with traumatic ossicular disruption with an intact tympanic membrane, who underwent endoscopic exploratory tympanotomy. A proposed algorithm was followed, to incorporate different traumatic ossicular possibilities. Assessment of hearing outcomes and surgical complications was performed six months post-operatively. Results: Incudostapedial dislocation was the most commonly encountered type of traumatic ossicular disruption (35.3 per cent). Air conduction threshold improved significantly following endoscopic ossiculoplasty, from 50.9 ± 6.35 dB pre-operatively to 22.35 ± 3.27 dB post-operatively, with successful air–bone gap closure. Conclusion: Endoscopic ear surgery is effective in the diagnosis and management of challenging cases of post-traumatic ossicular disruption with an intact tympanic membrane. [ABSTRACT FROM AUTHOR]

The article offers a perspective on long-term hearing progression and outcome of hearing loss in patients with Ménière's disease (MD). It refers to the presence of an additional pathophysiology, which could involve the trigeminovascular system and direct activation of the vestibular centers in the auditory system, as a possible mechanism underlying MD. Examples of serial audiograms in primary MD and migraine-related MD are cited.

Purpose: Standard clinical audiologic assessment is limited in its ability to capture variance in self-reported hearing difficulty. Additionally, the costs associated with clinical testing in audiology create financial barriers for hearing health care in developing countries like Mexico. This study used an open-source Spanish-language tool called PART (Portable Automated Rapid Testing) to test the hypothesis that a battery of assessments of auditory processing can complement standard clinical audiological assessment to better capture the variance of self-reported hearing difficulty. Method: Forty-three adults between 40 and 69 years of age were tested in Mexico City using a traditional clinical pure-tone audiogram, cognitive screening, and a battery of PART-based auditory processing assessments including a speechon- speech competition spatial release from masking task. Results were compared to self-reported hearing difficulty, assessed with a Spanish-language adaptation of the Hearing Handicap Inventory for the Elderly--Screening Version (HHIE-S). Results: Several measures from the PART battery exhibited stronger correlations with self-reported hearing difficulties than the pure-tone audiogram. The spatial release from masking task best captured variance in HHIE-S scores and remained significant after controlling for the effects of age, audibility, and cognitive score. Conclusions: The spatial release from masking task can complement traditional clinical measures to better account for patient's self-reported hearing difficulty. Open-source access to this test in PART supports its implementation for Spanish speakers in clinical settings around the world at low cost. [ABSTRACT FROM AUTHOR]

Purpose: For half a century, psycholinguists have been exploring the idea that developmental language disorders may have their roots in suprathreshold auditory dysfunctions, but results are inconclusive. Typical studies focus on relationships between temporal processing abilities and measures of various language skills at the time of testing, a proximal account. This study expanded that focus by testing three novel hypotheses: (a) Spectral processing impairments may be more responsible for language-learning deficits than temporal processing impairments. (b) Phonological sensitivity is likely the specific language skill most strongly affected by auditory (dys)functions. (c) Poor auditory functioning observed at young ages may wholly or partly recover, reducing the magnitude of relationship between those recovered functions and persistent language skills at older ages. Method: Sixty-six children (31 boys, 35 girls) 7-10 years of age participated: 36 with typical language and 30 with reading or speech disorder; from this sample two subsamples were designated: younger (7-8 years) and older (9-10 years) children. Four auditory measures were obtained of spectral modulation detection (0.5 and 2.0 cycles per octave) and temporal modulation detection (16 and 64 Hz). Four language measures were obtained, two lexicosyntactic and two phonological. Results: Younger children showed deficits in all auditory skills, but most strongly for spectral modulation detection at 0.5 cycles per octave; that measure was the only one for which older children showed deficits. Spectral modulation detection was the auditory function most strongly correlated with a language skill, and that language skill was phonological sensitivity. Conclusions: Early impairments in suprathreshold auditory functions, especially spectral processing, interfere with language acquisition at early stages, especially phonological sensitivity. Although auditory functions can recover to some extent, impairments in language skills persist, indicating that a distal account may more appropriately explain the relationship. [ABSTRACT FROM AUTHOR]

This exploratory study examined whether central auditory tests show differences between people living with HIV (PLWH) treated with two predominant antiretroviral drug therapy (ART) regimens. Cross-sectional. 253 PLWH (mean age 39.8 years) from the Shanghai Public Health Clinical Centre, China. The Hearing in Noise Test speech reception threshold (SRT) assessed central auditory function and the Montreal Cognitive Assessment (MoCA) assessed cognition. The relationship between ART regimen and SRT was evaluated with multivariable linear regression incorporating age, HIV duration, and peripheral hearing ability. Multivariable logistic regression was used to ascertain if SRT and ART regimen predicted MoCA impairment. The two predominant ART regimens differed by one drug (zidovudine or tenofovir). Participants taking the zidovudine-containing regimen had poorer SRT performance (p=.012) independent of age and hearing thresholds. MoCA scores did not differ between drug regimens, but a negative relationship was found between SRT and MoCA impairment (p=.048). ART regimens differed in their association with central auditory test performance likely reflecting neurocognitive changes in PLWH taking the zidovudine-containing regimen. Central auditory test performance also marginally predicted cognitive impairment, supporting further assessment of central auditory tests to detect neurocognitive deficits in PLWH. [ABSTRACT FROM AUTHOR]

Introduction: Vocants as infants' first vocalic utterances are produced laryngeally while the vocal tract is maintained in a neutral position. These "primitive" sounds have sometimes been described as largely innate and, therefore, as sounding alike in both healthy and hearing-impaired young infants. Objective: The objective of this study is to compare melody features of vocants, recorded during face-to-face interaction, between infants (N = 8) with profound congenital sensorineural hearing loss (HI group) and age-matched (N = 18) controls (CO) group. The question was as follows: does a lack of auditory feedback have a noticeable effect on melodic features of vocants? Methods: The cooing database totalled 6,998 vocalizations (HI: N = 2,847; CO: N = 4,151), all of which had been recorded during the observation period of 60–181 days of age. Identification of the vocants (N = 1,148) was based on broadband spectrograms (KAY-CSL) and auditory impressions. Fundamental frequency (F0) analyses were performed (PRAAT) and the pattern of the F0 contour (melody) analysed using specific in-lab software (CDAP, pw-project). Generalized mixed linear models were used to perform group comparisons. Results: There was a clear predominance of a simple rising-falling pattern (single melody arcs) in vocants of both groups. Nonetheless, significantly more complex contours, particularly, double-arc structures, were found in vocants of the CO group. Moreover, vocants of the HI group were shorter than those uttered by the CO group, while the mean F0 did not significantly differ. Conclusion: Vocants are characterized by both, innate features, found in HI and CO groups, and features that additionally require a functioning auditory system. Even at an early pre-linguistic stage, somatosensory sensations cannot compensate for a lack of auditory feedback. Vocants might be relevant in the early diagnosis of hearing disorders and assessments of the effectiveness of, or adjustments required to, hearing aids. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to use short-form visual analogue scale cochlear implantation questionnaires to evaluate subjective aspects at each out-patient visit. The correlation between subjective hearing tests using the short-form visual analogue scale and objective hearing outcomes was evaluated. Method: This study was conducted in a single centre. Cochlear implant users (n = 199) evaluated their hearing on a scale of 0 to 100 for the right, left and both ears. The Japanese speech perception test (CI-2004) Japanese monosyllable speech perception test (67-S) and cochlear implantation threshold were used for the objective cochlear implantation evaluation. Results: A significant correlation was found between the short-form visual analogue scale questionnaire and objective hearing outcome, for words (r = 0.64) and sentences (r = 0.62) in CI-2004 and 67-S (r = 0.56) tests. No significant correlation was found between the short-form visual analogue scale score and cochlear implantation threshold (r = −0.18). Conclusion: Short-form visual analogue scale cochlear implantation questionnaires mean cochlear implant users spend less time answering subjective visual analogue scale questionnaires, and clinicians estimate a patient's cochlear implantation hearing and abnormality by chronological evaluation. [ABSTRACT FROM AUTHOR]

Objective: Sudden hearing loss is a common presentation to ENT. In the authors' practice, patients often wait many weeks for formal hearing testing. This study aimed to assess whether a tablet-based hearing test, hearTest, could aid clinical decision-making within secondary care ENT. Method: This was a multi-centre, prospective, non-randomised study to assess the feasibility, usability and accuracy of hearTest. Results: In the sample, hearTest was shown to be an acceptable method of testing for hearing loss by both patients and clinicians. The 0.5–4 kHz range had an average clinical agreement rate of 95.1 per cent when compared with formal pure tone audiometry, deeming it an accurate test to diagnose hearing loss. Conclusion: The authors propose that hearTest can be used within ENT as a clinical decision support tool when manual audiometry is not immediately available. Within the authors' practice, hearTest is used to aid diagnosis and management of sudden sensorineural hearing loss. [ABSTRACT FROM AUTHOR]

Low- (or mild-) gain hearing aids (LGHAs) are increasingly considered for individuals with normal peripheral hearing but significant self-reported hearing difficulties (SHDs). This study assesses the benefits of LGHAs as a management option for individuals with normal hearing thresholds (NHTs) and SHDs, comparing LGHA use and benefit to individuals with non-significant hearing difficulties (NHDs) and those with peripheral hearing loss. Questionnaires addressing hearing aid usage, benefit, hearing difficulties, and tinnitus were administered to 186 individuals who self-identified as hearing aid users in a sample of 6652 service members who were receiving their annual hearing tests. Participants were divided into SHD and NHD groups based on the normative cutoff of the Tinnitus and Hearing Survey-Hearing Subscale (THS-H), and into hearing impairment (HI) and NHT based on their audiometric air-conduction thresholds. Individuals with SHDs and NHTs reported higher LGHA usage and benefit than individuals with NHDs and NHTs. Comparable use and benefit were noted between groups with SHDs regardless of peripheral hearing loss status. The findings support LGHAs as a suitable management option for individuals with NHTs and SHDs, as indicated by hearing aid use and benefit. Quantifying the level of perceived auditory processing deficits (i.e., SHDs), notably with the THS-H, enhances sensitivity in identifying those who may benefit the most from this treatment option. [ABSTRACT FROM AUTHOR]

This report presents a case of ring chromosome 7 syndrome with bilateral cleft lip and palate. A four-year-old boy presented with bilateral cleft lip and palate, microcephaly, clenched toes, cafe-au-lait spots, a history of epilepsy, and severe intellectual disability. Genetic karyotyping revealed 46 XY r(7) (p22q36). His cheiloplasty and delayed palatoplasty were successful. A review of 22 previous r(7) patients revealed that 22.7% had cleft lip and/or palate. This case demonstrates the importance of a multidisciplinary evaluation for cleft patients, particularly those with syndromic features and global developmental delay. [ABSTRACT FROM AUTHOR]

Background: It has long been believed that the patulous eustachian tube is a unique but uncommon condition, with an estimated incidence ranging from 0.3 to 6.6% in the general population. Hearing one's own voice and breathing, or autophony and aerophony, are the most common symptoms of PET, along with frequent auditory fullness. Aim: This study is to establish a standardized protocol for the audiological evaluation of patulous Eustachian tube using acoustic reflex decay test during different breathing tasks. Methods: Between January 2022 and December 2022, the ENT department at Suez Canal University Hospitals undertook an observational case-control study. Fifty-two adult patients who present to the Suez Canal University ENT department with complaints of autophony, auditory fullness, or aerophony are diagnosed with patulous eustachian tube dysfunction through endoscopic examination of the tympanic membrane's synchronized movement with respiration. Results: The incidence rate of PET among adults was approximately 3 patients/1000 patients/year. The age of the whole studied group ranged from 20 to 60 years with mean ± SD of 37.4 ± 12.6 years. They included 23 males (44.2%) and 29 females (55.8%). The most common symptom among the studied group was aural fullness (46%), while the least common symptom was aerophony (12%); the most common risk factor among the studied patients was allergy (46.2%), while the least common was radiotherapy (3.9%); 66.7% of the patients with GERD were males, while 66.7% of the patients who lost weight were females; 58.3% of the patients with allergies were females, and also 60% of the patients with thin built were females. In the case group, there is a significant higher change of middle ear compliance in ipsilateral nostril breathing than the mouth breathing and nasal breathing. The sensitivity of the acoustic reflex decay test to diagnose PET with reference to the gold standard test is 88.5% (23/26*100), the specificity is 100% (26/26*100), and the positive predictive value is 100% (23/23*100). Conclusion: The sensitivity of the acoustic reflex decay test to diagnose PET with reference to the gold standard test is high, and the specificity is very high with very good diagnostic accuracy. [ABSTRACT FROM AUTHOR]

It has been established that blast exposure and brain injury can result in self-reported and measured auditory processing deficits in individuals with normal or near-normal hearing sensitivity. However, the impaired sensory and/or cognitive mechanisms underlying these auditory difficulties are largely unknown. This work used a combination of behavioral and electrophysiological measures to explore how neural stimulus discrimination and processing speed contribute to impaired temporal processing in blast-exposed Veterans measured using the behavioral Gaps-in-Noise (GIN) Test. Results confirm previous findings that blast exposure can impact performance on the GIN and effect neural auditory discrimination, as measured using the P3 auditory event-related potential. Furthermore, analyses revealed correlations between GIN thresholds, P3 responses, and a measure of behavioral reaction time. Overall, this work illustrates that behavioral responses to the GIN are dependent on both auditory-specific bottom-up processing beginning with the neural activation of the cochlea and auditory brainstem as well as contributions from complex neural networks involved in processing speed and task-dependent target detection. [ABSTRACT FROM AUTHOR]

Hearing loss is one of the most common sensory impairments and hearing aids are the most common unmet assistive device need among individuals with a disability. The benefits of hearing interventions are well-documented as they are known to deter the sequalae of hearing loss including social isolation, poor mental health, falls and cognitive decline. Identifying trends in hearing aid users can provide valuable information for improving access to hearing loss interventions. Data were retrieved from ICES databases that were used to generate a cohort of 372,448 individuals in Ontario, Canada, who first claimed hearing aids between April 2007 and March 2018 through the Assistive Devices Program. The data indicated that the frequency distribution of hearing aids has steadily inclined since 2007. The mean age of hearing aid users was 70.25 ± 14.70 years and higher neighbourhood income quintile was associated with greater hearing aid use (p < 0.001). Most first claims occurred after visiting primary care physicians (70.60%) compared with otolaryngology (13.39%). An examination of clinical comorbidities revealed hypertension (63.41%), and diabetes (24.93%) to be the most common. Regression analysis demonstrated a positive associated between age and most comorbidities. Furthermore, higher neighbourhood income quintiles were associated with a reduced risk of having the examined comorbidities. This study examines patient demographics and clinical comorbidities in a cohort of hearing aid users in Ontario. The results identify associations between demographics and comorbidities that provide information relevant for improving access to hearing interventions and clinical decision-making in primary care. Screening for hearing loss (using an audiogram) in elderly individuals that manage multiple comorbidities, and any patient with significant risk factors for hearing loss (e.g., noise exposure history, prior ototoxic medications, prior head injury, history of ear surgery, family history of hearing loss) will identify deficits and direct appropriate hearing interventions. Improving access to care in low-income communities should include community-based education around expectation management and communication strategies to reinforce proper use and care of hearing devices. Geographic proximity to hearing testing facilities and hearing aid dispensaries is a significant barrier to hearing rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that children with intermittent exotropia (IXT) have a higher rate of psychiatric abnormalities as they grow up, such as attention deficit. This study explored visual and hearing attention among children with IXT, and evaluated its association with clinical characteristics and cognitive development. Methods: Forty-nine children with a diagnosis of IXT and 29 children with traditional development were recruited. The Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) was used to measure the subjects' full-scale response control quotient (FSRCQ), full-scale attention quotient (FSAQ), auditory response control quotient (ARCQ), auditory attention quotient (AAQ), visual response control quotient (VRCQ), and visual attention quotient (VAQ). The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess their cognitive function. The differences between the scores of children with IXT and normal controls were analyzed. Results: The results showed that the FSRCQ, FSAQ, ARCQ, AAQ, VRCQ, and VAQ of children with IXT were all lower than those of normal controls with the same age (P < 0.05). The level of attention was significantly correlated with the age of strabismus onset (P < 0.05), but not with the degree of strabismus, stereopsis, or fusion control score. In addition, audiovisual attention was correlated significantly with their cognitive development level. The random forest classifier prediction model showed that age of strabismus onset was an important predictor of attention. Conclusion: Children with IXT have lower visual and auditory attention and control than their peers, and the age of onset of strabismus may be a major factor. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has caused various implications on physical and mental health of human beings. It included several symptoms involving the auditory vestibular system. This study aims to investigate the impact of active COVID-19 infection on central and peripheral auditory pathways. Method: Two groups of subjects were involved in the research: Group I consisted of 45 individuals with no history of COVID-19, while Group II included 41 individuals who were diagnosed with COVID-19 through RT-PCR testing. The audiological battery used in this study included Pure tone audiometry, Digit in Noise test, Dichotic CV test, and Pitch pattern test, all of which were administered online. Testing was conducted in two phases for both groups. Phase 1 testing took place within the first 7 days of a positive RT-PCR result, while Phase 2 testing occurred within a week of a negative RT-PCR test. Additionally, participants completed a questionnaire to provide information on general health conditions and their otological symptoms. Results: The results from Phase 1 testing revealed that Group II exhibited statistically lower scores in all the audiological tests compared to Group I (control group). However, during Phase 2 testing, this significant difference was no longer observed between both groups. Conclusion: Based on the findings, it can be inferred that the audiological pathway was compromised during the active infection stage of COVID-19. Therefore, this study highlights changes in performance concerning tests that assess the central auditory system during the infection period. Trial registration: SH/IRB/RP/24. Registered 12 January 2021. [ABSTRACT FROM AUTHOR]

This study aimed to assess the validity of a high-frequency audiometry tool based on Bayesian learning to provide a reliable, repeatable, automatic, and fast test to clinics. The study involved 85 people (138 ears) who had their high-frequency thresholds measured with three tests: standard audiometry (SA), alternative forced choice (AFC)-based algorithm, and Bayesian active (BA) learning-based algorithm. The results showed median differences within ±5 dB up to 10 kHz when comparing the BA with the other two tests, and median differences within ±10 dB at higher frequencies. The variability increased from lower to higher frequencies. The BA showed lower thresholds compared to the SA at the majority of the frequencies. The results of the different tests were consistent across groups (age, hearing loss, and tinnitus). The data for the BA showed high test–retest reliability (>90%). The time required for the BA was shorter than for the AFC (4 min vs. 13 min). The data suggest that the BA test for high-frequency audiometry could be a good candidate for clinical screening. It would add reliable and significant information without adding too much time to the visit. [ABSTRACT FROM AUTHOR]

The treatment of refractory elderly Meniere's disease is a challenge. To investigate the efficacy of tympanostomy tube placement in elderly patients with Meniere's disease. 31 patients over 60 years old with Meniere's disease who had failed medical treatment and underwent tympanostomy tube placement. Vertigo control, hearing level, tinnitus, and ear fullness were recorded and analyzed preoperatively and postoperatively. All patients completed a 6-month follow-up. At 6 months postoperatively,complete control, substantial control and limited control of vertigo were achieved in 10 (32%), 13 (42%), and 6 (19%) patients respectively. Two patients (6%) reported no substantial improvement. Twelve patients completed a 2-year follow-up. At 2 years postoperatively, complete control, substantial control and limited control of vertigo were achieved in 3 (25%), 5 (42%), and 1 (8%) patients respectively. Three (25%) patients showed no significant improvement in vertigo. The majority of patients reported significant improvement in the functional level scale, the Dizziness Handicap Inventory scores, and ear fullness at 6 months and 2 years postoperatively. Tympanostomy tube placement may reduce vertigo attacks and improved the quality of life in elderly patients with Meniere's disease. [ABSTRACT FROM AUTHOR]