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Purpose: Cauliflower ear in wrestlers can lead to hearing impairment. This study primarily aims to assess the hearing of wrestlers with bilateral cauliflower ears and determine their external ear canal (EEC) resonance frequencies. Our second aim is to evaluate their hearing quality, speech, and spatial perception. Method: This study included 28 male wrestlers aged 18--35 years with bilateral cauliflower ears, as well as 27 male participants in the control group with no wrestling history. The participants' hearing thresholds were determined across the frequency range of 125--16000 Hz for air-conduction and 500--4000 Hz for bone conduction. EEC resonance frequencies were measured. Additionally, all participants completed the Turkish version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire. Results: Wrestlers with cauliflower ears exhibited significantly higher hearing thresholds, particularly at frequencies above 4000 Hz (p < .05). Analysis of EEC resonance showed a shift to higher frequencies in the second resonance peak of the right ear (p < .001) and the first resonance peak of the left ear (p = .045). SSQ scores revealed that wrestlers had higher spatial perception (p = .046), hearing quality (p = .004), and general scores (p = .042) in comparison to the control group. Conclusions: Blunt traumas in wrestlers, leading to cauliflower ear, can result in hearing loss. Moreover, deformities in the external ear affect the resonance frequencies of the EEC. Therefore, it is crucial to advocate for the use of ear protection equipment among wrestlers. When fitting hearing aids, attention should be given to changes in the EEC resonance frequency. [ABSTRACT FROM AUTHOR]

Purpose: Bone conduction hearing devices (BCDs) that deliver sound across the skin (i.e., transcutaneous) are suitable for some individuals who have con- ductive or mixed hearing losses. Prescriptive targets for percutaneous devices are available, for example, from the Desired Sensation Level--Bone Conduction Hearing Device (DSL-BCD) algorithm. These targets, however, may require modification for use with transcutaneous BCDs. The current study investigated three key variables that may inform target modification: (a) comparison of thresholds measured using an audiometric bone conduction (BC) transducer versus transcutaneous BCDs that offer in situ threshold measurement, (b) trans- cutaneous BCD default force level outputs versus recommended DSL percuta- neous BC targets, and (c) the preferred listening levels (PLLs) of adults wearing transcutaneous BCDs in a laboratory setting. Method: Bilateral conductive hearing loss was simulated in 20 normal-hearing adults via earplugs. Thresholds were measured using a B-71 BC transducer and two commercially available BCDs coupled to a soft headband. DSL percu- taneous BC targets were generated, and PLLs were obtained for a 60-dB SPL speech stimulus. Force level outputs were measured using a skull simulator on the Audioscan Verifit2 at the hearing aids' default settings and at the partici- pants' PLL for each device. Results: On average, audiometric BC thresholds were significantly better than those measured in situ with each BCD. PLLs were similar to prescribed targets for one device with the smoother response shape and agreed in the high fre- quencies for both devices. Conclusions: In situ thresholds are significantly higher than audiometric BC thresholds, suggesting that device-based in situ measurement more accurately accounts for the signal transmission from transcutaneous BCDs. PLLs differed from the percutaneous targets and varied between devices, which may indicate that either target modifications or manipulations of device frequency response shaping are needed to approximate PLL with transcutaneous BCD devices. [ABSTRACT FROM AUTHOR]

This paper introduces EmoBone, a comprehensive audio‐only emotional bone‐conducted speech dataset featuring speakers from various countries. The dataset comprises speeches from 28 individuals representing 10 different nations, with each participant delivering 10 sentences designed to evoke distinct emotions. In addition to an air‐conducted microphone, the recordings utilized bone conduction technology, transmitting sound directly to the speakers' inner ears, ensuring high‐quality emotional speech recordings. To assess the validity of the dataset, 80 university students from Bangladesh listened to the recordings and successfully identified the expressed emotions with an accuracy exceeding 76%. Statistical methods were also employed to evaluate the reliability of the dataset, revealing a high level of agreement among raters. EmoBone, with a cumulative duration surpassing 19 h and 15 680 unique utterances, stands as the most extensive emotional speech dataset available. This makes it a valuable tool for studying how emotional speech varies across cultures. Furthermore, due to its utilization of bone conduction technology, EmoBone facilitates the study of acoustic features in emotional speech from diverse dimensions. The data that supports the findings of this study is available upon reasonable request. © 2024 Institute of Electrical Engineers of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Hearing loss is the most prevalent neurosensory disorder in humans, with significant implications for language, social and cognitive development if not diagnosed and treated early. The present systematic review and meta-analysis aimed to determine the rate of hearing screening pass and genetic screening failure [universal newborn hearing screening (UNHS) pass/genetic failure] and to investigate the advantages of combining newborn hearing and genetic screening for newborn hearing impairment. The PubMed, Embase and Cochrane databases were searched from inception to September 2023 to identify studies reporting the combination of neonatal hearing screening with genetic screening. Duplicate literature, unpublished literature, studies with incomplete data, animal experiments, literature reviews and systematic studies were excluded. All the data were processed by STATA15.1 statistical software. A total of nine cross-sectional studies were included in this meta-analysis. The sample sizes ranged from 1,716 to 180,469, and there were a total of 377,688 participants. The pooled results revealed that the prevalence of passing the UNHS while failing genetic screening was 0.31% (95% CI, 0.22-0.41%). The prevalence of UNHS pass and gap junction protein beta 2 and solute carrier family 26 member 4 variant screen failure was 0.01% (95% CI, 0.00-0.02%) and 0.00% (95% CI, 0.00%), respectively, while the prevalence of mitochondrially encoded 12S RRNA variant screening failure and UNHS pass was 0.21% (95% CI, 0.18-0.26%). Combined screening has a significant advantage over pure hearing screening, especially in terms of identifying newborns with mitochondrial gene mutations that render them sensitive to certain medications. In clinical practice, decision-makers can consider practical circumstances and leverage the benefits of combined newborn hearing and genetic screening for early diagnosis, early counseling, and early intervention in patients with hearing loss. [ABSTRACT FROM AUTHOR]

Introduction: Although the Baha 5SP has been commercially available for six years, very few studies have been performed on the device's efficacy. The current study aims to evaluate the characteristics and audiological results in patients with severe‐to‐profound mixed hearing loss fitted with this superpower sound processor. Methods: This retrospective evaluation was conducted at a tertiary referral centre where a series of 82 adult patients with severe‐to‐profound mixed hearing loss were implanted with a percutaneous bone‐anchored hearing system and fitted with a superpower sound processor between 2016 and 2019. Patients with incomplete or unreliable audiological data (n = 24) were excluded, resulting in 58 data sets for analysis. The main outcome measures were unaided and aided pure‐tone thresholds and aided free‐field speech perception in quiet. Results: The median unaided air conduction (AC) threshold averaged across 0.5, 1 and 2 kHz (PTA0.5–2kHz) of all patients was 75 dB hearing loss (HL); the median unaided AC averaged across 1, 2 and 4 kHz (PTA1–4kHz) was 84 dB HL. For bone conduction and direct bone conduction, the median PTA0.5–2kHz was 52 and 47 dB HL, respectively. With the superpower device, the median free‐field speech reception threshold was 54 dB sound pressure level (SPL), and the median speech perception score at 65 dB SPL was 80%. Conclusions: At least 75% of the patients reached a maximum phoneme score of 70%. For patients with lower scores, the superpower device still provides a substantial hearing benefit. This makes the superpower device particularly suitable for patients with severe‐to‐profound mixed hearing loss with a contraindication for conventional hearing aids and/or cochlear implants. [ABSTRACT FROM AUTHOR]

Background: Music is the art of combining vocals or instruments to form the beauty of expression. Perception of the sounds includes two types of processing: bottom-up and top-down. Earlier studies have reported that musicians outperformed nonmusicians in the discrimination of frequency, intensity, duration, temporal processing tasks, and working memory. The present study compared musicians' and nonmusicians' differential sensitivity and auditory processing abilities in children and younger adults. Methods: A total of 120 participants in the age range of 9–15 years and 18–25 years were recruited for the study and were further divided into four groups: children musicians, children nonmusicians, young adult musicians, young adult nonmusicians group A, B, C, D, respectively. Each group consisted of 30 participants. Further, all the participants were assessed with Differential sensitivity tests such as DLI, DLF, DDT, GDT, and Dichotic CV. Results: The study revealed a high statistical difference in the DLI, DLF, DDT, GDT, and DCV, indicating that children who learned music had better scores than those who did not. A similar trend was observed for younger adults, wherein musicians scored better than nonmusicians on differential sensitivity and auditory processing abilities. Conclusion: It was observed that younger adults (musicians and nonmusicians) showed no difference in Dichotic CV, which shows that the maturation and auditory ability of the younger adults are stabilized. Hence, the present study infers that intensive musical training influences superior performance in auditory perceptual tasks. [ABSTRACT FROM AUTHOR]

Background: Cochlear Implant (CI) has been shown to improve speech comprehension, sound localization and tinnitus in adults with Single-Sided-Deafness (SSD) compared to standard treatment currently available in the Dutch setting such as a CROS (Contralateral Routing of Signals) hearing device or a BCD (Bone Conduction Device). Also, for the pediatric population with SSD, CI has shown to be clinically meaningful. Because currently no information is available on the health economic effects of CI in adults and children with SSD in the Netherlands, a cost-utility analysis was conducted. Methods: We developed a Markov cohort model, for both the adult and pediatric SSD population, with three states: implant, no implant, and dead. CI was compared with the Bone Conduction Device (BCD) treatment, requiring surgery and no specific treatment. The time horizon of the model was lifelong, costs were discounted with 3% and effects with 1.5%. A societal perspective was taken, including productivity costs in the analysis, with costing data based on publicly available prices for the Netherlands. Values for clinical outcome parameters, i.e. hearing gain, and event probabilities were based on existing literature. Deterministic and probabilistic sensitivity analyses as well as scenario analyses were performed to outline uncertainty of individual and combined parameters. Results: Mean per patient costs for CI in the adult population were €194,051 (95%-CrI €177,274 to €211,108) compared to the total costs of €185,310 (95%-CrI €182,367 to €194,142) for BCD resulting in a cost difference of €8,826 (95%-CrI -€5,020 to €18,252). Compared to no treatment, the cost difference was -€25,089 (95%-CrI -€31,678 to -€6,003). Adults who were treated with CI gained 18.41 (95%-CrI 18.07 to 18.75) quality adjusted life years (QALY) whereas BCD patients gained 15.81 QALYs (95%-CrI 15.53 to 16.10), a difference of 2.60 QALYs (95%-CrI 2.15 to 3.05). The Incremental Cost Effectiveness Ratio (ICER) for adults with CI was determined to be €3,494/QALY gained. Patient without treatment gained 13.46 QALY (95%-CrI 13.20 to 13.73), a difference of 4.95 (95%-CrI 4.87 to 5.01) resulting in CI dominating no treatment. The ICER remained below the Dutch threshold of €20,000/QALY. The probabilistic sensitivity analyses confirmed the results. For children, CI dominated when compared to BCD and when compared to no treatment. Compared to BCD, CI led to a cost saving of €29,611 (95%-CrI -€126,800 to €54,375) and compared to no treatment, CI resulted in a cost saving of €57,658 (95%-CrI -€146,687 to €5,919). The incremental QALY gain compared to BCD was 7.22 (95%-CrI 4.19 to 8.55) and 26.03 (95%-CrI 20.82 to 31.06) compared to no treatment. Conclusions: Based on the results of this health economic evaluation with a Markov cohort model, it is very likely that CI is cost-effective compared to BCD and to no treatment in the Dutch adult and pediatric population with SSD. In both populations the ICER was below the Dutch cost-effectiveness threshold of €20,000/QALY. [ABSTRACT FROM AUTHOR]

Objectives: Single-sided deafness (SSD) is often accompanied by tinnitus, resulting in a decreased quality of life. Currently, there is a lack of high level of evidence studies comparing different treatment options for SSD regarding tinnitus reduction. This randomized controlled trial (RCT) evaluated the effect of a cochlear implant (CI), bone conduction device (BCD), contralateral routing of sound (CROS), and no treatment on tinnitus outcomes in SSD patients, with follow-up extending to 24 months. Methods: A total of 120 adult SSD patients were randomized to three groups: CI, a trial period with first a BCD on a headband, then a CROS, or vice versa. After the trial periods, patients opted for a BCD, CROS, or no treatment. At the start of follow-up, 28 patients were implanted with a CI, 25 patients with a BCD, 34 patients had a CROS, and 26 patients chose no treatment. The Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), the Visual Analog Scale (VAS), and the Hospital Anxiety and Depression Scale (HADS) were completed at baseline and at 3, 6, 12, and 24 months of follow-up. Results: The CI and BCD groups showed significantly decreased tinnitus impact scores. The CI group showed the largest decrease, which was already observed at 3 months of follow-up. Compared to the baseline, the median THI score decreased by 23 points, the TQ score by 17 points, and the VAS score by 60 points at 24 months. In the BCD group, the TQ score decreased by 9 points, and the VAS decreased by 25 points at 24 months. The HADS anxiety and depression subscale showed no indication for anxiety or depression at baseline, nor at 24 months, for all groups. Conclusion: In this RCT, SSD patients treated with a CI or BCD showed an overall decrease in tinnitus impact scores up to 24 months compared to baseline. The CI group reported a stable and the largest reduction. Cochlear implants appear to be superior to BCD and CROS, and no treatment for achieving partial or complete resolution of tinnitus in patients with SSD. [ABSTRACT FROM AUTHOR]

We present a new rehabilitation system based on novel principles, which consists of an auditory augmented reality (AR) headset we originated. The auditory AR headset, which does not cover both ears, allows users to hear both Real and Virtual environmental sounds at the same time. It can also be used in combination with Hearing Aids. We have studied a system to support hearingimpaired people and conducted a test evaluation. The system was able to provide convenience akin to “reading glasses for sound” to those who had mild hearing disabilities. Furthermore, by combining the system with surrounding speakers, a completely novel virtual auditory illusion was created in which the sound image jumps into the ear and runs away. We name this “proximal auditory AR (PAAR)” system. This system directly affects the unconscious level of reflexes for maintaining a standing position and can generate very subtle body motion disturbance. Using this system, we can modulate the standing posture and observe the autonomic nerve system’s ability to subliminally compensate for the disturbance, using a stabilometer that measures body sways by center of pressure (COP). We observed a significant difference in the declination of COP only when using the PAAR, which is combined with array speakers and the auditory AR headphone, compared using a conventional closed-type and a bone-conduction headphone. By analyzing such big data of physical movement through machine learning, we expect to realize new systems for diagnosis, rehabilitation, function maintenance, and fall prevention. [ABSTRACT FROM AUTHOR]

Background/Objectives: Otosclerosis is a relatively uncommon condition that causes conductive hearing loss in children. The preferred treatment for adults is stapedotomy, while for individuals under 18 years old, there is an ongoing discussion about the best treatment approach. Thus, the surgical procedure for the stapes in pediatric patients continues to be a subject of debate. This study aimed to evaluate the results of stapes surgery in children, trying to understand, based on our results, whether this is actually the most suitable option. Methods: The study included 18 patients who underwent surgery between January 2013 and December 2023. The patients' ages ranged from 11 to 18 years, with an average age of 14.7. Out of the total 21 surgeries, three patients opted for bilateral surgery. Pre- and post-operative data were compared, focusing on the mean air conduction (AC) and bone conduction (BC) thresholds at frequencies of 0.5, 1, 2, and 4 kHz. Additionally, pre-operative thresholds and the post-operative air–bone gap (ABG) were examined. Results: After a year, the air–bone gap was effectively reduced to 10 dB or less in 94% of the 21 cases, and to 20 dB or less in 98% of all cases. Conclusions: Our results and research in the field have consistently shown that stapedotomy, when conducted by skilled otosurgeons, is a reliable and successful procedure for a considerable number of patients. The outcomes it generates are similar to those achieved through the procedure conducted during adulthood. [ABSTRACT FROM AUTHOR]

The infrafloccular approach in microvascular decompression (MVD) surgery for hemifacial spasm (HFS) was investigated for the prevention of hearing complications. Retrospective analysis of 136 patients who underwent MVD for HFS in 2019. The infrafloccular approach for MVD was adopted to resolve the symptom and protect hearing function. Postoperative hearing function was evaluated subjectively and objectively within 30 postoperative days, and later mainly subjectively. Postoperative condition of mastoid air cells based on the CT scan of the following day was also recorded. No final postoperative subjective hearing impairment was found in all patients. Mastoid air cells were opened in 105 patients, and subjective hearing impairment was recorded in 57 patients within 30 postoperative days, but all improved later. Increases in thresholds of greater than 10 dB in air conduction were observed in 28 patients, including 26 of transient conductive hearing loss (increases in the threshold of less than or equal to 10 dB). The other 2 patients with increases in the threshold of greater than 10 dB in both air and bone conduction had improvement confirmed by later audiometry. Infrafloccular approach in MVD for HFS provides a good hearing outcome. Inclusion of postoperative hearing conditions in the later period is ideal for a precise hearing evaluation. [ABSTRACT FROM AUTHOR]

The inner ear is responsible for balance and auditory function. Sensorineural hearing loss (SNHL) affects auditory function across various age groups. Vestibular apparatus, particularly the otolith organ can also be affected in cases of SNHL because of the close proximity of the otolith organs with the cochlea inside the bony labyrinth. The otolith organs can be assessed with Subjective Visual vertical test (SVV), which is a simple, rapid, non-invasive test with high sensitivity and specificity. Present study was conducted with the objective to compare the SVV parameters between normal and SNHL patients and to correlate between the degree of tilt in SVV with severity of SNHL. A convenient sample size of 60 was taken of which 30 were control and 30 were SNHL patients. PTA and SVV were performed on both groups and results were analysed in IBM SPSS version 26. Age stratified analysis between the control group and SNHL group for the age group 20–40 years and for > 40 years revealed a significant statistical difference in the average static SVV (P = 0.019 and P = 0.009 for age group 20–40 years and > 40 years respectively) and dynamic anti clockwise SVV (P = 0.024 and P = 0.031 for age group 20–40 years, and > 40 years respectively) between the control group and the SNHL group. Correlational analysis also shows a moderate correlation between the bone conduction threshold and the various SVV parameters. Statistical difference of SVV parameters between the two groups suggests a possible early involvement of the otolith organ in SNHL. As such the utility of SVV as an early marker for otolith dysfunction needs to be further explored. It may be worthwhile to follow up the patients of SNHL longitudinally and assess the otolith function with SVV at periodic intervals to identify any progression. [ABSTRACT FROM AUTHOR]

Background: Otosclerosis is a primary osteodystrophy of the otic capsule that causes stapedo-vestibular ankylosis. Its diagnosis is suspected on the basis of clinical and audiometric elements, basically in the presence of conductive hearing loss with a normal eardrum. The CT-scan is an essential examination for the preoperative evaluation of otosclerosis. The aim of our study was to evaluate the use of CT-scanning in predicting the functional outcome of otosclerosis surgery by correlating postoperative audiometric results and preoperative CT findings. Methods: We conducted a retrospective study at the ENT Department in association with the Medical Imaging Department of our hospital, over a period of 8 years, from January 2014 to December 2022 and involving 90 patients (104 ears). Results: The average age of our patients was 40 years with extremes ranging from 22 to 61 years. We noted a sex ratio of 0.38. The preoperative CT-scan showed signs of otosclerosis in 87% of the cases and infra-radiological forms in 13% of the cases. Veillon stage II was the most frequent radiological stage encountered with a percentage of 48%. A good audiometric evolution, defined by a closure of postoperative Air Bone Gap (ABG ≤ 20 dB) and by an improvement of Bone Conduction (BC gain ≥ 0), was recorded in 86 cases (82.7%) for ABG and in 84 cases (80.8%) for BC gain. Scanographic predictive factors of poor postoperative outcome for ABG and BC gain were: advanced stages (Veillon stage III and IV), endosteal effraction, and round window involvement. According to multivariate analysis, only the extent of otosclerotic foci was directly and independently associated with the postoperative audiometric outcome. Conclusion: The CT-scan is an essential examination in the preoperative evaluation of otosclerosis. It allows a positive diagnosis to be made and evaluate the extension of otosclerosis. Moreover, thanks to the analysis of the extent of the otosclerosis foci, mainly by the Veillon classification, the CT-scan allows to predict the postoperative audiometric prognosis. [ABSTRACT FROM AUTHOR]

Cerebellofaciodental syndrome characterized with dysmorphic features, intellectual disability, and brain anomalies. Now its clinical spectrum expanded more manifestations including bilateral sensorineural hearing impairment and inner ear malformation. Here, we report a 14‐month‐old boy with global developmental delay and hearing disorder. Whole exome sequencing (WES) revealed the compound heterozygous variants [NM_001519.4: c.652 T > G (p.W218G); c.915 + 1G > T] in the BRF1 gene which inherited from his parents, respectively. The MRI results showed hypoplastic cerebellar vermis, enlarged cisterna magna, and prominent fourth ventricle, the rehabilitation therapy failed to improve the symptoms for our patient. Our finding expands the genetic spectrum of BRF1 variants, which indicates patients with the developmental delay caused by BRF1 variants require other treatments instead of rehabilitation. [ABSTRACT FROM AUTHOR]

Mutations in microRNA-96 (MIR96) cause autosomal dominant deafness-50 (DFNA50), a form of delayed-onset hearing loss. Genome editing has shown efficacy in hearing recovery through intervention in neonatal mice, yet editing in the adult inner ear is necessary for clinical applications, which has not been done. Here, we developed a genome editing therapy for the MIR96 mutation 14C>A by screening different CRISPR systems and optimizing Cas9 expression and the sgRNA scaffold for efficient and specific mutation editing. AAV delivery of the KKH variant of Staphylococcus aureus Cas9 (SaCas9-KKH) and sgRNA to the cochleae of presymptomatic (3-week-old) and symptomatic (6-week-old) adult Mir9614C>A/+ mutant mice improved hearing long term, with efficacy increased by injection at a younger age. Adult inner ear delivery resulted in transient Cas9 expression without evidence of AAV genomic integration, indicating the good safety profile of our in vivo genome editing strategy. We developed a dual-AAV system, including an AAV-sgmiR96-master carrying sgRNAs against all known human MIR96 mutations. Because mouse and human MIR96 sequences share 100% homology, our approach and sgRNA selection for efficient and specific hair cell editing for long-term hearing recovery lay the foundation for the development of treatment for patients with DFNA50 caused by MIR96 mutations. Editor's summary: Mutations in MIR96, a microRNA expressed in inner hair cells, result in autosomal dominant deafness-50 (DFNA50), a form of nonsyndromic hearing loss. Here, Zhu et al. optimized a CRISPR-Cas9 system to specifically erase mutations in MIR96 and show that adeno-associated virus (AAV) delivery of this editing system to the cochleae of presymptomatic and symptomatic mice carrying one of the human mutations (the 14C>A mutation) promoted hair cell survival and improved hearing long term. These results suggest that microRNA editing might be a promising strategy to preserve auditory function in patients with DFNA50. —Daniela Neuhofer [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]

This study aimed to develop Janus-, cross-network-, and coaxial-structured piezoelectric–conductive polymer nanofibers through electrospinning to mimic the piezoelectricity of bone and facilitate the conduction of electrical signals in bone tissue repair. These nanofibers were constructed using the piezoelectric polymer polyvinylidene fluoride, and the conductive fillers reduced graphene oxide and polypyrrole. The influence of structural features on the electroactivity of the fibers was also explored. The morphology and components of the various structural samples were characterized using SEM, TEM, and FTIR. The electroactivity of the materials was assessed with a quasi-static d33 meter and the four-probe method. The results revealed that the piezoelectric–conductive phases were successfully integrated. The Janus-structured nanofibers demonstrated the best electroactivity, with a piezoelectric constant d33 of 24.5 pC/N and conductivity of 6.78 × 10−2 S/m. The tensile tests and MIP measurements showed that all samples had porosity levels exceeding 70%. The tensile strength of the Janus and cross-network structures exceeded that of the periosteum (3–4 MPa), with average pore sizes of 1194.36 and 2264.46 nm, respectively. These properties indicated good mechanical performance, allowing material support while preventing fibroblast invasion. The CCK-8 and ALP tests indicated that the Janus-structured samples were biocompatible and significantly promoted the proliferation of MC3T3-E1 cells. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the presented study was to compare the audiological benefit achieved in cochlear implant (CI) patients who, in principle, could still have been treated with an active middle ear implant (AMEI) with a group of AMEI users. Methods: Results of 20 CI patients with a pure-tone average (PTA) of 70 dB HL prior to surgery were compared with a group of 12 subjects treated with a Vibrant Soundbridge (VSB). Pre-surgical comparison included PTA for air conduction and bone conduction, maximum speech recognition score for monosyllabic words (WRSmax), and aided monosyllabic word recognition at 65 dB SPL. One year after surgery, aided monosyllabic speech recognition score at 65 dB SPL was compared. Results: Mean PTA for air conduction in the VSB group was significantly lower than in the CI group (4.8 dB, Z = − 2.011, p < 0.05). Mean PTA for bone conduction in the VSB group was also significantly lower than in the CI group (23.4 dB, Z = − 4.673, p < 0.001). WRSmax in the VSB group was significantly better than in the CI group (40.7%, Z = − 3.705, p < 0.001). One year after treatment, there was no significant difference in aided speech perception in quiet between both subject groups. Conclusion: Comparison of the two methods showed equivalent results for both treatments in subjects with a borderline indication. Not only pure-tone audiometry results but, particularly, speech perception scores pre-surgery should be taken into account in preoperative counseling. [ABSTRACT FROM AUTHOR]

Introduction: For the treatment of single-sided deafness (SSD), common treatment choices include a contralateral routing of signals (CROS) hearing aid, a bone conduction device (BCD), and a cochlear implant (CI). The primary aim of this study was to compare speech understanding in noise and binaural benefits in adults with postlingual SSD between preoperative unaided baseline, preoperative CROS and BCD trial devices, and CI, following recommendations from a consensus protocol. In addition, we investigated the effect of masker type on speech understanding. Methods: This was a prospective study with twelve participants. Binaural effects of head shadow, squelch, summation, and spatial release from masking were assessed by measuring speech reception thresholds (SRTs) in five different spatial target-masker configurations using two different maskers: two-talker babble (TTB), and speech-shaped noise (SSN). Preoperatively, participants were assessed unaided and with CROS and BCD trial devices. After cochlear implantation, participants were assessed at 1, 3, and 6 months post-activation. Results: For TTB, significant improvements in SRT with a CI relative to preoperatively unaided were found in all spatial configurations. With CI at 6 months, median benefits were 7.8 dB in SSSDNAH and 5.1 dB in S0NAH (head shadow), 3.4 dB in S0N0 (summation), and 4.6 dB in S0NSSD and 5.1 dB in SAHNSSD (squelch). CROS yielded a significant head shadow benefit of 2.4 dB in SSSDNAH and a significant deterioration in squelch of 2.5 dB in S0NSSD and SAHNSSD, but no summation effect. With BCD, there was a significant summation benefit of 1.5 dB, but no head shadow nor squelch effect. For SSN, significant improvements in SRT with CI compared to preoperatively unaided were found in three spatial configurations. Median benefits with CI at 6 months were: 8.5 dB in SSSDNAH and 4.6 dB in S0NAH (head shadow), 1.4 dB in S0N0 (summation), but no squelch. CROS showed a significant head shadow benefit of 1.7 dB in SSSDNAH, but no summation effect, and a significant deterioration in squelch of 2.9 dB in S0NSSD and 3.2 dB in SAHNSSD. With BCD, no binaural effect was obtained. Longitudinally, we found significant head shadow benefits with a CI in SSSDNAH in both maskers at all postoperative intervals and in S0NAH at 3 and 6 months post-activation. Conclusion: With a CI, a clear benefit for masked speech perception was observed for all binaural effects. Benefits with CROS and BCD were more limited. CROS usage was detrimental to the squelch effect. [ABSTRACT FROM AUTHOR]

Introduction: The mechanism of non-osseous bone conduction pathways, involving the intracranial contents (ICC) of the skull, is still not well understood. This study aimed to investigate the influence of the ICC on the skull bone wave propagation, including dependence on stimulation location and coupling. Methods: Three Thiel-embalmed whole-head cadaver specimens were studied before and after the removal of the ICC. Stimulation was via the electromagnetic actuators from commercial bone conduction hearing aids. Osseous pathways were sequentially activated by mastoid, forehead, and bone-anchored hearing aid location stimulation via a 5-Newton steel headband or percutaneously implanted screw. Non-osseous pathways were activated by stimulation on the eye and dura via a 5-Newton steel headband and a custom-made pneumatic holder, respectively. Under each test condition, the 3D motion of the superior skull bone was monitored at ∼200 points. Results: The averaged response of the skull surface showed limited differences due to the removal of the ICC. In some isolated cases, the modal pattern on the skull surface showed a trend for an upshift (∼1/2 octave) in the observed natural frequencies for drained heads. This was also consistent with an observed trend for an upshift in the transition frequency in the estimated deformation across the lateral surfaces of the temporal bones. Such changes were consistent with the expected reduction in mass and damping due to the absence of the ICC. Conclusion: Overall, the ICC affect to a limited extent the motion of the skull bone, with a limited trend for a reduction of its natural frequencies. [ABSTRACT FROM AUTHOR]

Bone conduction systems are sometimes not well tolerated due to the tension on the skull. Therefore, a brand non-surgical device was developed, the ADHEAR (MED-EL, Innsbruck, Austria). It is based on a novel fixation system using an adhesive adapter, which allows for a more comfortable and efficient mechanical transmission of the acoustic signal and that can be used as treatment for conductive hearing loss. The purpose of the study is to evaluate the performance of ADHEAR in two patients with unilateral conductive hearing loss. An 8-years-old patient with external ear canal stenosis obtained a functional gain of 28.75 dB, while a 16-years-old patient with Goldenhar syndrome showed a recovery of 53.75 dB. Therefore, both cases suggest that ADHEAR appears to be an effective treatment for pediatric patients who due to the medical condition cannot be treated surgically or fitted with conventional hearing aids.

Speech enhancement, or SE, is a method of converting an input speech signal into a target signal with improved quality of voice and readability. To hear the voice, the skeleton bone vibrates ultra smooth thanks to bone conduction. The benefits of Bone-Conducted Microphone (BCM) speech include noise reduction and enhanced communication quality in high-noise environments. To acquire signals and precisely model word phonemes, BCM relies on the placement of bones. Certain computer techniques are expensive and ineffective in simulating signal phonemes. Three wavelet transform techniques are presented in this work: complex continuous wavelet transforms (CCWT), steady wavelet transforms (SWT), and discrete wavelet transforms (DWT). The right ramp, the voice box, and the mastoid were the three distinct bony locations for which the speech intelligibility of the BCM signal was evaluated. The listener evaluated the comprehension of the speech after obtaining the BCM signal for Tamil words. Speech quality is enhanced by the location of the larynx bone in comparison to alternative calculation methods. [ABSTRACT FROM AUTHOR]

Abstract Background The standard methods for diagnosing otosclerosis (OS) include clinical and audiological testing. Radiologic imaging continues to expand with use in diagnosis, staging, surgery planning, and outcomes. Objective To determine if high resolution computed tomography (HRCT) imaging advances to the audiological findings in the diagnosis of otosclerosis. Methods This prospective randomized controlled study was conducted from June 2018 to June 2022. Fifty patients with OS who divided into two subgroups: group 2a, 50 early OS ears, and group 2b, 35 ears with late OS. The controls includes 50 individuals who have healthy ears (group 1). All participants had otorhinolaryngology examination, audiological evaluation and HRCT imaging. Results Early OS had higher air conduction thresholds than control, and late OS had considerably higher air conduction thresholds than either the early or control subjects (p

Background: The standard methods for diagnosing otosclerosis (OS) include clinical and audiological testing. Radiologic imaging continues to expand with use in diagnosis, staging, surgery planning, and outcomes. Objective: To determine if high resolution computed tomography (HRCT) imaging advances to the audiological findings in the diagnosis of otosclerosis. Methods: This prospective randomized controlled study was conducted from June 2018 to June 2022. Fifty patients with OS who divided into two subgroups: group 2a, 50 early OS ears, and group 2b, 35 ears with late OS. The controls includes 50 individuals who have healthy ears (group 1). All participants had otorhinolaryngology examination, audiological evaluation and HRCT imaging. Results: Early OS had higher air conduction thresholds than control, and late OS had considerably higher air conduction thresholds than either the early or control subjects (p < 0.001). Early OS patients had higher bone conduction threshold (BCT) than control, while late OS patients had higher BCT than both early and control subjects (p < 0.001). In early and late OS, there is a significant association between bone conduction of 11 dB and 21.6 dB, respectively (P = 0.004), and a significant air–bone gap of 25.5 and 31 dB, respectively (P = 0.03). HRCT showed a sensitivity of 75% and high specificity 92% with accuracy 83% in early OS and sensitivity of 78% and high specificity 94% with accuracy 86% in late OS. Conclusion: HRCT is a more sensitive and specific diagnostic tool for OS than audiometry. HRCT could discriminate between early and late OS, suggesting that it can be used to do so with a high degree of confidence. [ABSTRACT FROM AUTHOR]

This study describes the design of a transducer for bone conduction implants that combines a piezoelectric element and a displacement amplifier. To develop a displacement amplifier with the maximum possible amplification ratio, theoretical analysis was performed to derive the parameters that affect the amplification ratio. Parametric sweep analysis was conducted to calculate the amplification ratio according to changes in the various parameters. The resulting optimal displacement amplifier afforded the maximum amplification ratio when the beam thickness, depth, inclination angle, and length were 0.15 mm, 1.2 mm, 6.5°, and 4 mm, respectively. The displacement amplifier with these optimal parameter values amplified the piezoelectric element displacement by approximately 7.7‐fold. Frequency characteristic analysis by weight was performed to derive a mechanical resonance location with frequency characteristics that appropriately compensated for hearing loss. As a result of this analysis, when a weight of 0.7 g was applied to the displacement amplifier, the mechanical resonance was that required for bone conduction implant transducers. [ABSTRACT FROM AUTHOR]

Sound transmission to the human inner ear by bone conduction pathway with an implant attached to the otic capsule is a specific case where the cochlear response depends on the direction of the stimulating force. A finite element model of the temporal bone with the inner ear, no middle and outer ear structures, and an immobilized stapes footplate was used to assess the directional sensitivity of the cochlea. A concentrated mass represented the bone conduction implant. The harmonic analysis included seventeen frequencies within the hearing range and a full range of excitation directions. Two assessment criteria included: (1) bone vibrations of the round window edge in the direction perpendicular to its surface and (2) the fluid volume displacement of the round window membrane. The direction of maximum bone vibration at the round window edge was perpendicular to the round window. The maximum fluid volume displacement direction was nearly perpendicular to the modiolus axis, almost tangent to the stapes footplate, and inclined slightly to the round window. The direction perpendicular to the stapes footplate resulted in small cochlear responses for both criteria. A key factor responsible for directional sensitivity was the small distance of the excitation point from the cochlea. [ABSTRACT FROM AUTHOR]

Objective: Audio processors (AP) are the external components of hearing implants. User satisfaction with the performance and comfort of their AP is a critical factor in ensuring daily use, which leads to improved hearing outcomes. The aim of this study was to construct and validate an Arabic language translation of the APSQ for use among Arabic-speaking clinicians and patients. Design: The original APSQ was translated into the Arabic language using cross-cultural adaptation measures. The final questionnaire was administered to CI users in electronic form. Study sample: 117 CI users (64 female) participated. A total of 179 ears were assessed. Results: High levels of satisfaction with audio processors were observed among CI users. Item and scale analyses indicate that this version of the APSQ measure a homogeneous and valid construct. Conclusion: The Arabic version of the APSQ captures user satisfaction with hearing implant audio processors. [ABSTRACT FROM AUTHOR]

Objectives : Petrous bone cholesteatoma (PBC) is a rare condition of the petrous portion of the temporal bone. Treatment of choice consists of radical surgical removal, paying attention to protect the facial nerve and inner ear as far as possible. The aim of the present study was to evaluate the efficacy of modified translabyrinthine techniques in preserving hearing function and the use of the adjuvant endoscopic techniques in a group of PBC patients. Methods : This study comprised 16 cases of PBCs surgically treated in our Department. Pre- and post-operative hearing status was assessed with pure tone audiometry and speech discrimination and graded according to the Gardner- Robertson classification system. Facial function was based on the House Brackman (HB) classification. PBCs were grouped using Sanna's classification. The choice of surgical technique was based on the above findings together with preoperative evidence. Post-operative follow-up ranged from 1 to 10 years and also included Computed Tomography and Magnetic Resonance Imaging assessment. Results : PBCs were classified as follows: 37.5% infralabyrinthine; 43.75% supralabyrinthine; and 18.75% massive. Preservation of the bone conduction threshold was feasible in 62.5% of patients. For supralabyrinthine PBCs a subtotal petrosetomy was performed in all cases and hearing preservation was possible in 57% of them: an adjuvant endoscopic approach was performed in 43%. Infralabyrinthine PBCs were treated using a modified translabyrinthine approach with preservation of bone conduction in 83% of patients; an adjuvant endoscopic approach was performed in 50% cases. One patient with a massive cholesteatoma was treated by modified translabyrinthine approach, preserving a serviceable level of hearing. In all massive cases, an adjuvant endoscopic approach was performed. In 2 patients with preoperative palsy, facial nerve function showed an improvement. The follow-up period revealed evidence of limited recurrence at CT imaging in 2 patients. Conclusions : The introduction of modified surgical approaches, able to preserve the anatomical-functional structures, have shown an improvement of post-operative hearing outcomes. [ABSTRACT FROM AUTHOR]

Objective: To examine the surgical, audiological and patient-reported outcomes of the Osia 2 implant. Methods: Data from 14 consecutive subjects undergoing implantation between April 2022 and November 2023 were reviewed. Ten subjects had conductive hearing loss, three had mixed hearing loss and one had single-sided deafness (SSD). Warble tone thresholds, Pure Tone Average (PTA4) and Speech Discrimination Score (SDS) in quiet and in noise were determined unaided and aided. The subjective outcome was determined from two standardized questionnaires: (1) International Outcome Inventory for Hearing Aids (IOI-HA) and (2) Speech, Spatial and Qualities of Hearing Scale 12 (SSQ12b). Results: Unexpected postoperative pain was found in four cases. The warble tone thresholds exhibited a consistent reduction across all frequencies, contributing to a mean decrease of 27 dB in the aided PTA4. SDS demonstrated notable improvements, with a 57.3% increase at 50 dB and a 55.6% increase at 65 dB. In noise, SDS exhibited a 43.9% improvement. The mean IOI-HA Score was 3.8, and the mean overall score for SSQ12b was 6.6, with consistent findings across the subgroups. Conclusions: The Osia device emerges as a promising recommendation for individuals with conductive or mixed hearing loss, possibly also for those with SSD. Its safety and efficacy profile aligns with the broader category of active transcutaneous devices, demonstrating a reduced risk of wound infection compared to percutaneous alternatives. Both audiological assessments and subjective evaluations revealed positive outcomes. [ABSTRACT FROM AUTHOR]

The objective of this study is to determine the noise effective masking level (EML) and inter-aural attenuation (IA) for click and CE-Chirp signals presented though a Radioear B-81 to elicit the auditory brainstem responses in normally hearing, young adults. A total of 26 conveniently sampled adults (13 male and 13 female, aged 18–25 years; 52 ears), with pure-tone hearing thresholds not >15 dB nHL at octave frequencies from 250 to 8000 Hz, and subjective thresholds for the bone-conducted click and CE-Chirp not >10 dB nHL. At stimulus intensities of 30 and 40 dB nHL, the contralateral EML was 67.86 ± 0.78 and 77.80 ± 0.81 dB SPL (respectively) for the click and 72.11 ± 0.74 and 83.53 ± 0.78 dB SPL (respectively) for the CE-Chirp. At stimulus intensities of 30 and 40 dB nHL, the IA was 3.46 ± 2.34 and 3.38 ± 2.03 dB (respectively) for both the click and the CE-Chirp. EML and IA values are reported for click and CE-Chirp signals presented at 30 and 40 dB nHL though a Radioear B-81 to elicit the ABR in normally hearing, young adults. [ABSTRACT FROM AUTHOR]

The tympanic membrane forms a barrier between the external auditory canal and the middle ear. In the inactive mucosal type of chronic otitis media, there is a perforation in the tympanic membrane which is surgically managed by Myringoplasty. Estrogen as a growth factor has been shown to have a mitogenic effect on keratinocytes thus hastening the rate of epithelialization following injury. This property of estrogen is being studied in this study for its role in the outcomes of myringoplasty. This study was carried out from January 2021 to December 2022 in the Department of Otorhinolaryngology, of a tertiary teaching hospital in North India. Patients were assessed by history, examination, otoscopy, Audiometry, and oto-endoscopy. A total of 88 patients were taken out of which 44 patients underwent myringoplasty in which topical estrogen (estradiol valerate solution) was used, and the remaining 44 patients were taken as controls. Patients were then assessed post-operatively based on Audiometry results and graft uptake status. In the estrogen group successful Graft uptake was in seen 40 (90.9%) patients and failed in 4 (9.1%), while in the control group, it was successful in 37 (84.1%) patients and failed in 7 (15.9%), statistically there was no significant difference between two groups in terms of graft uptake (p value = 0.334). Post-operatively, in the estrogen group, the mean change in Air Conduction (AC) was 15.5 dB, the change in the air-bone gap (ABG) was 11.5 dB and for Bone Conduction (BC) it was 3.2 dB. However, in the control group mean post-operative changes in Air Conduction, Air-Bone Gap, and Bone Conduction were 12 dB, 10.7 dB, and 0.8 dB respectively. Statistically, there was a significant difference in postoperative changes in AC (p value = 0.011) and BC (p value = 0.009) between the two groups. There was no significant difference in post-operative changes in Air-Bone Gap (p value = 0.571). Topical Estrogen (Estradiol valerate) solution is cost-effective, with enriched growth factors that accelerate tympanic membrane perforation closure following myringoplasty and resulted in significant improvement in hearing thresholds both for Air Conduction and Bone Conduction. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of piston diameter in patients undergoing primary stapes surgery on audiometric results and postoperative complications. Methods: A retrospective single-center cohort study was performed. Adult patients who underwent primary stapes surgery between January 2013 and April 2022 and received a 0.4-mm-diameter piston or a 0.6-mm-diameter piston were included. The primary and secondary outcomes were pre- and postoperative pure-tone audiometry, pre- and postoperative speech audiometry, postoperative complications, intraoperative anatomical difficulties, and the need for revision stapes surgery. The pure-tone audiometry included air conduction, bone conduction, and air–bone gap averaged over 0.5, 1, 2 and 3 kHz. Results: In total, 280 otosclerosis patients who underwent 321 primary stapes surgeries were included. The audiometric outcomes were significantly better in the 0.6 mm group compared to the 0.4 mm group in terms of gain in air conduction (median = 24 and 20 dB, respectively), postoperative air–bone gap (median = 7.5 and 9.4 dB, respectively), gain in air–bone gap (median = 20.0 and 18.1 dB, respectively), air–bone gap closure to 10 dB or less (75% and 59%, respectively) and 100% speech reception (median = 75 and 80 dB, respectively). We found no statistically significant difference in postoperative dizziness, postoperative complications and the need for revision stapes surgery between the 0.4 and 0.6 mm group. The incidence of anatomical difficulties was higher in the 0.4 mm group. Conclusion: The use of a 0.6-mm-diameter piston during stapes surgery seems to provide better audiometric results compared to a 0.4-mm-diameter piston, and should be the preferred piston size in otosclerosis surgery. We found no statistically significant difference in postoperative complications between the 0.4- and 0.6-mm-diameter piston. Based on the results, we recommend always using a 0.6-mm-diameter piston during primary stapes surgery unless anatomical difficulties do not allow it. [ABSTRACT FROM AUTHOR]

Purpose: To compare the audiological outcomes, tympanic membrane (TM) healing rates and complication rates in patients undergoing endoscopic underlay and over–under tympanoplasty type I (TTI). Methods: The study includes 95 patients who underwent endoscopic TTI in the period between 2018 and 2023: 56% of the patients had the underlay technique and 41% had the over–under technique. Data regarding pre- and postoperative hearing, perforation characteristics, surgical procedures, graft types and complications were retrospectively analyzed. Audiometrical assessment included air conduction (AC) and bone conduction (BC) pure tone averages (PTA) and air–bone gap (ABG), pre- and postoperatively. Results: Both underlay and over–under techniques significant improved AC PTA, with a mean ABG improvements of 5.9 dB and 7.2 dB, respectively. There was no significant difference in BC PTA between pre- and post-operative, indicating no inner ear damage in both techniques. The over–under technique showed a significantly higher TM closure rate (94.4%) compared to the underlay technique (80.6%). Complications were rare, with only one case of TM lateralization requiring revision surgery. Conclusions: Endoscopic TTI is an effective treatment in improving auditory function in chronic middle ear diseases. In our cohort, the detachment of the umbo does not negatively influence the postoperative hearing results and does not increase rate of complications. Moreover, the over–under technique demonstrates superior TM closure rates, making it a valuable option for specific cases. However, future prospective studies with larger sample sizes and longer term follow-up are needed to validate these findings and provide more comprehensive insights. [ABSTRACT FROM AUTHOR]

Objective: Bone conduction hearing implants are a well-established method of hearing rehabilitation in children and adults. This study aimed to review any changes in provision in England. Methods: The total number of bone conduction hearing implantations performed was analysed from 2012 to 2021 utilising Hospital Episode Statistics data for England. Results: The total number of procedures has increased by 58 per cent. One-stage bone conduction hearing implantations in adults accounts for the largest proportion of this increase (93 per cent of the total). The number performed in children has remained stable and accounts for 73 per cent (n = 433) of all two-stage procedures. Conclusion: The data show that bone conduction hearing implant surgery is becoming increasingly popular, particularly in adults. This has correlated with the increase in availability, national recommendations and choice of devices. [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]

Background: Sheep have been proposed as a large-animal model for studying cochlear implantation. However, prior sheep studies report that the facial nerve (FN) obscures the round window membrane (RWM), requiring FN sacrifice or a retrofacial opening to access the middle-ear cavity posterior to the FN for cochlear implantation. We investigated surgical access to the RWM in Hampshire sheep compared to Suffolk-Dorset sheep and the feasibility of Hampshire sheep for cochlear implantation via a facial recess approach. Methods: Sixteen temporal bones from cadaveric sheep heads (ten Hampshire and six Suffolk-Dorset) were dissected to gain surgical access to the RWM via an extended facial recess approach. RWM visibility was graded using St. Thomas' Hospital (STH) classification. Cochlear implant (CI) electrode array insertion was performed in two Hampshire specimens. Micro-CT scans were obtained for each temporal bone, with confirmation of appropriate electrode array placement and segmentation of the inner ear structures. Results: Visibility of the RWM on average was 83% in Hampshire specimens and 59% in Suffolk-Dorset specimens (p = 0.0262). Hampshire RWM visibility was Type I (100% visibility) for three specimens and Type IIa (> 50% visibility) for seven specimens. Suffolk-Dorset RWM visibility was Type IIa for four specimens and Type IIb (< 50% visibility) for two specimens. FN appeared to course more anterolaterally in Suffolk-Dorset specimens. Micro-CT confirmed appropriate CI electrode array placement in the scala tympani without apparent basilar membrane rupture. Conclusions: Hampshire sheep appear to be a suitable large-animal model for CI electrode insertion via an extended facial recess approach without sacrificing the FN. In this small sample, Hampshire specimens had improved RWM visibility compared to Suffolk-Dorset. Thus, Hampshire sheep may be superior to other breeds for ease of cochlear implantation, with FN and facial recess anatomy more similar to humans. [ABSTRACT FROM AUTHOR]

Speech is produced by a nonlinear, dynamical Vocal Tract (VT) system, and is transmitted through multiple (air, bone and skin conduction) modes, as captured by the air, bone and throat microphones respectively. Speaker specific characteristics that capture this nonlinearity are rarely used as stand-alone features for speaker modeling, and at best have been used in tandem with well known linear spectral features to produce tangible results. This paper proposes Recurrent Plot (RP) embeddings as stand-alone, non-linear speaker-discriminating features. Two datasets, the continuous multimodal TIMIT speech corpus and the consonant-vowel unimodal syllable dataset, are used in this study for conducting closed-set speaker identification experiments. Experiments with unimodal speaker recognition systems show that RP embeddings capture the nonlinear dynamics of the VT system which are unique to every speaker, in all the modes of speech. The Air (A), Bone (B) and Throat (T) microphone systems, trained purely on RP embeddings perform with an accuracy of 95.81%, 98.18% and 99.74%, respectively. Experiments using the joint feature space of combined RP embeddings for bimodal (A–T, A–B, B–T) and trimodal (A–B–T) systems show that the best trimodal system (99.84% accuracy) performs on par with trimodal systems using spectrogram (99.45%) and MFCC (99.98%). The 98.84% performance of the B–T bimodal system shows the efficacy of a speaker recognition system based entirely on alternate (bone and throat) speech, in the absence of the standard (air) speech. The results underscore the significance of the RP embedding, as a nonlinear feature representation of the dynamical VT system that can act independently for speaker recognition. It is envisaged that speech recognition too will benefit from this nonlinear feature. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsThe objective is to evaluate the electroacoustic performance of the B250 transducer and to compare it with the two most widely used audiometric transducers B71 and B81.The electroacoustic performance was evaluated in terms of sensitivity level, distortion, maximum hearing level and electrical impedance.Six B250 prototype transducers were evaluated and compared with published data of B71 and B81 together with complementary measurements of maximum hearing level at 125 Hz and phase of electrical impedance. Differences in reference equivalent threshold vibratory force levels were estimated by comparing hearing threshold measurements of 60 healthy ears using B81 and B250.B250 has approximately 27 dB higher sensitivity levels than both B71 and B81 at 250 Hz and can generate higher maximum hearing level at low frequencies: 11.8 to 35.8 dB (125–1000 Hz) higher than B71, and 1.4 to 18.6 dB (125–750 Hz) higher than B81. The maximum average difference in reference threshold force levels was 13.5 ± 8.7 dB higher for B250 at 250 Hz compared to B81.B250 can produce higher output force with less distortion than B71 and B81, especially at 125 and 250 Hz, which could possibly improve low frequency investigations of the audio-vestibular system. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chronic unilateral hearing loss causes imbalanced auditory input to the brain that triggers cortical reorganization. The effect of sensorineural hearing loss on the central auditory system (CAS) has been thoroughly studied, while there is a paucity of research on the effect of conductive hearing loss (CHL). The aim of this study was to assess the P1-N1-P2 cortical auditory evoked response potential (CAEP) in adult individuals with chronic acquired unilateral CHL. METHODS: This study included 108 participants of both genders: 54 patients with unilateral chronic CHL who were compared to well-matched 54 controls. All were subjected to history-taking, otologic examination, basic audiological evaluation, and bone conduction N1-P2 CAEP. RESULTS: The affected ears of the cases showed highly statistically significant shorter CAEPs N1, P2, N1-P2 latencies but not P1, and showed highly statistically significant larger N1, P2, N1P2, amplitude than the control group. Latencies decreased and amplitudes increased as the degree of CHL increased, but were not affected by patients’ age, side, or duration of the CHL. Cases with tinnitus had statistically significant and worse results than those without tinnitus. CONCLUSION: Unilateral chronic CHL might enhance neurocortical plasticity, with greater changes occurring at greater degrees of the CHL. [ABSTRACT FROM AUTHOR]

BACKGROUND: Temporal bone (TB) fractures are frequently accompanied by intracranial injury. This study aimed to analyze combined intracranial injuries in relation to functional changes in the inner ear, including those of the contralateral ear, in patients with TB fractures. METHODS: Ninety-four patients (mean age: 35.6 ± 18.7 years, M : F=67 : 27) diagnosed with unilateral TB fracture were included. Bone conduction (BC) threshold, word recognition score (WRS), and changes in vestibular function were compared based on intracranial injuries, focusing on the contralateral side. RESULTS: Various types of intracranial injuries were observed (67.9%). Among these, a significant association between traumatic brain injury (TBI) and otic capsule-violating fractures was noted. The BC threshold on the fractured side significantly deteriorated in patients with TBI. Additionally, a significantly worse BC threshold was confirmed on the contralateral side in patients with TBI, intracranial hemorrhage (ICH), and contrecoup injury. The follow-up BC threshold did not improve or differ, regardless of high-dose steroid administration. The initial WRS and canal paresis in the bithermal caloric test were not significantly different in the presence of each intracranial injury. Concurrent fluctuations in the pressure of the cerebrospinal fluid space and perilymphatic space were speculated to be the potential underlying mechanisms. CONCLUSION: A significantly worse BC threshold was confirmed on the contralateral side of patients with TBI, contrecoup injury, ICH, and on fracture sides of patients with TBI. [ABSTRACT FROM AUTHOR]

Cranial measurements have been widely used in various studies in wildlife sciences, ranging from understanding predator ecology to wildlife forensics. However, detailed description of morphometry and sexual dimorphism of the skull of gaur Bos gaurus gaurus is lacking. The present study was undertaken to determine the sexual dimorphism based on the cranial measurements of gaur. A total of 12 individual gaur skulls of male (n = 6) and female (n = 6) were studied in the field from the naturally deceased animals between January 2018 and December 2021 in different ranges of Bandhavgarh tiger reserve (BTR), Madhya Pradesh, India. The skull measurements were analysed using univariate and multivariate statistics to determine whether cranial dimensions could be used to differentiate male and female skulls reliably. A total of 43 morphometrical parameters grouped into nine indices were calculated. Select morphometrical parameters viz PL, GFL, AKI, LBB, LFB, GBEE, GBAN, BPOP and GTCH were significantly different (p < 0.05) between sexes, whereas GBAN were significantly higher in female skulls. The measurements demonstrated that the skull of the gaur was dolichocephalic as the profile length and the otion to otion breath in both male and female were <75% of the length. Overall, 28 linear measurements of both the sexes were statistically significant (p < 0.05; <0.01). The calculated indices revealed that the foramen magnum index in the female gaur were significantly higher. In calculated cranial indices the facial index (a) was higher in female and facial index (b) were higher in males. The two important parameters, facial breadth in facial index (a) and the greatest breadth in facial index (b) were positively correlated, though facial index (a) was statistically not significant between the sexes. The greater inner length of the foramen magnum in female skull resulted in foramen being oval whereas it was circular in males. These parameters were decisive for sexual dimorphism, skull comparison and craniological studies. This study ascertained that the frontal index and skull index had no significant influence and were not good indices for discriminating skulls between male and female. Based on the Principal Component Analysis, it was found that skull of male and female gaurs exhibits differences in cranial morphology viz. cranial profile length or total length (PL) and the least inner height of the temporal groove (LIHT). The findings of the present study provide baseline information on various craniometrical measurements of skull of gaur, indices and parameters for sex identification that can be effectively used in understanding sex biased predation ecology, provide base line information to describe variation across its geographic range, and in identifying skulls recovered in wildlife offence cases. [ABSTRACT FROM AUTHOR]

Purpose: This multicentric, retrospective study aimed to analyze the short-term safety and effectiveness of the mCLIP Partial Prosthesis. Methods: Patients underwent tympanoplasty with implantation of a mCLIP Partial Prosthesis. Follow-up examination included ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative minimum and maximum follow-up period was not defined. Thus, the follow-up times of each study center were different, which resulted in different follow-up times for the audiological analysis and for adverse events (AE). Results: 72 (66 adults, 6 children) patients were implanted with the mCLIP Partial Prosthesis. 68 (62 adults, 6 children) patients underwent audiological examination; all 72 patients were examined for adverse events. All patients (N = 68): 72.1% of the patients showed a PTA4 ABG of ≤ 20 dB. Individual post-operative bone conduction (BC) PTA4 thresholds were stable in 67 patients. The mean post-operative follow-up time was 78 ± 46 days. Children (N = 6): 5 out of 6 children showed a PTA4 ABG of ≤ 20 dB. None of the children reported a BC PTA4 deterioration of > 10 dB HL after the implantation. The mean post-operative follow-up time was 101 ± 45 days. Adverse events (all patients, N = 72): 15 (14 adults, 1 child) patients had AEs (27 AEs and 2 Follow-Ups). The mean post-operative follow-up time was 375 days. Conclusion: Clinical data show satisfactory audiological parameters after implantation of the mCLIP Partial Prosthesis. The prosthesis is safe and effective for implantation in children and adults. Trial registration number: NCT05565339, 09 September 2022, retrospectively registered. [ABSTRACT FROM AUTHOR]

Bone conduction testing has been a part of the audiometric test battery since the 1920s (Jones and Knudsen, 1924). However, in our experience, there remains some variance in how bone conduction testing is performed and documented in clinics, leading to confusion for students and sometimes mistrust among professionals. Over the years, the divergence between textbook instructions and clinical practice has remained. This article highlights current practices through clinical scenarios in an effort to unearth their origins and to provide guidance supported by established protocols and guidelines. [ABSTRACT FROM AUTHOR]

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Objective: The presence of Carhart's notch at 2000 Hz in otosclerosis links the changed bone conduction for this frequency with the otosclerotic process occurring in the oval window. The aim of this study is to perform an audiometric assessment of the effectiveness of surgical treatment of otosclerosis depending on the incidence of Carhart's notch. Methods: The analysis included 116 patients treated surgically for the first time due to otosclerosis. Patients were divided into 4 groups depending on the occurrence of Carhart's notch, determined by pure-tone audiometry (PTA) before the surgery and 36 months afterward. The mean value of bone conduction thresholds was calculated for 500 Hz, 1000 Hz, 2000 Hz, and 3000 Hz in the groups in which the Cahart's notch was observed. This value of bone conduction (BC) was a reference point for further analysis in patients who had no preoperative or postoperative Carhart's notch. Results: The analysis indicated that Cahart's notch in preoperative PTA is a statistically significant improvement factor for average BC. It was found that over a longer observation period, the presence of Carhart's notch has adverse effects on the size of the postoperative air-bone gap, and consequently on hearing improvement after surgical treatment. A comparison between patients from the two groups without preoperative Carhart's notch found that no beneficial effects of the surgery on speech comprehension were observed regarding high-level sensorineural hearing loss (SNHL). Conclusions: (1) In a long-term observation post-stapedotomy, average BC values were found to improve. Nevertheless, the improvement is less evident in patients with preoperative Carhart's notch. (2) Disappearance of Cahart's notch after surgical treatment of otosclerosis is a good prognosis of improvement in speech audiometry. (3) Deep SNHL in the absence of Carhart's notch in PTA constitutes a bad prognostic factor for improvement in speech audiometry in patients qualified for surgical treatment of otosclerosis. [ABSTRACT FROM AUTHOR]

Objective: Cochlear receptors are sensitive to vibratory stimuli. Based on this sensibility, bone-anchored hearing aids have been introduced to correct unilateral or bilateral conductive or mixed hearing loss and unilateral deafness. The vestibular system is also sensitive to the vibratory stimulus and this type of response is used in clinics to test its functionality. Being aware of this double separated sensibility, we wondered whether bone vibration, which activates the acoustic receptors of patients with bone conduction aids, can also influence the functionality of the vestibular system. Methods: To this end, we recruited 12 patients with a bone-anchored hearing aid and evaluated their vestibular function with and without an activated vibratory acoustic device. Results: Our results show that the vibratory stimulus delivered by the bone conduction aid also reaches and stimulates the vestibular receptors; this stimulation is evidenced by the appearance or modification of some nystagmus findings during bedside vestibular testing. Despite this, none of these patients complained of dizziness or vertigo during prosthesis use. Nystagmus that appeared or changed during acoustic vibratory stimulation through the prosthesis was almost all predominantly horizontal, unidirectional with respect to gaze or body position, inhibited by fixation, and most often consistent with vestibular function tests indicating peripheral vestibular damage. Conclusions: The findings of sound-evoked nystagmus seem to indicate peripheral rather than central vestibular activation. The occurrence of some predominantly horizontal and high-frequency induced nystagmus seems to attribute the response mainly to the utricle and lateral semicircular canal. [ABSTRACT FROM AUTHOR]

The etiology of sensorineural hearing loss is heavily influenced by genetic mutations, with approximately 80% of cases attributed to genetic causes and only 20% to environmental factors. Over 100 non-syndromic deafness genes have been identified in humans thus far. In non-syndromic sensorineural hearing impairment, around 75–85% of cases follow an autosomal recessive inheritance pattern. In recent years, groundbreaking advancements in molecular gene therapy for inner-ear disorders have shown promising results. Experimental studies have demonstrated improvements in hearing following a single local injection of adeno-associated virus-derived vectors carrying an additional normal gene or using ribozymes to modify the genome. These pioneering approaches have opened new possibilities for potential therapeutic interventions. Following the PRISMA criteria, we summarized the AAV gene therapy experiments showing hearing improvement in the preclinical phases of development in different animal models of DFNB deafness and the AAV gene therapy programs currently in clinical phases targeting autosomal recessive non syndromic hearing loss. A total of 17 preclinical studies and 3 clinical studies were found and listed. Despite the hurdles, there have been significant breakthroughs in the path of HL gene therapy, holding great potential for providing patients with novel and effective treatment. [ABSTRACT FROM AUTHOR]