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Purpose: The purpose of this study was to explore the dynamics of multifrequency tone bursts on the masseter vestibular evoked myogenic potential (mVEMP) parameters. Furthermore, it sought to determine the optimal frequency tuning of mVEMP responses. Method: Twenty young adults with normal hearing sensitivity participated in the study. Bilateral tone burst evoked mVEMPs were obtained using the zygomatic montage at 250-, 500-, 750-, 1000-, 1500-, and 2000-Hz stimulation frequencies. Self-monitoring biofeedback was given during the procedure to confirm the tension of the masseter muscle between 49.9 and 150.6 rms. Furthermore, the electromyography (EMG) scaling was done to avoid any muscle-related irregularities. Results: Tone burst evoked mVEMPs were found to be 100% present at the stimulation frequencies of 250, 500, 750, and 1000 Hz. There were no ear and gender effects seen for any of the frequencies. Significant shortening of the P1 and N1 latencies with increasing stimulation frequencies was observed. The peak-to-peak amplitude was the highest at 500 Hz and lowest at 2000 Hz tone bursts under both EMG scaled and unscaled conditions. Conclusion: The present revealed higher response rates and larger amplitudes study of mVEMP at lower frequencies, and, therefore, the frequency tuning was seen for the stimulation frequency at 500 Hz. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed at comparing narrowband Claus Elberling levelspecific chirp (NB CE-Chirp)-, click-, and tone burst-evoked masseteric vestibular evoked myogenic potentials (mVEMPs). Method: Within-group study design and purposive sampling were performed. A total of 25 normal-hearing individuals participated in the study. The zygomatic electrode montage was used to elicit ipsilateral mVEMP responses using a 500-Hz NB CE-Chirp, a click of 100-µs duration, and a 500-Hz tone burst stimulus. Each of the responses was analyzed based on the absolute peak latency of P11 and N21, the electromyography-scaled peak-to-peak amplitude of the P11-N21 complex, and the interaural asymmetry ratio. Results: A total of 50 ears were tested and had 100% mVEMP responses. The latencies of click-evoked and 500-Hz NB CE-Chirp-evoked mVEMPs were significantly shorter than those of 500-Hz tone burst-evoked mVEMPs (p < .05) for both ears. It revealed a significantly superior P11-N21 amplitude of the 500-Hz NB CE-Chirp and tone burst than clicks for both ears. Intraclass correlation coefficient revealed moderate to excellent test-retest reliability for mVEMP parameters across three different stimulations. Conclusion: The present study supports 500 Hz NB CE-Chirps as effective and reliable stimuli as tone bursts in eliciting mVEMP responses. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to explore the various parameters of multifrequency narrowband Claus Elberling chirp (NB CE-chirp) evoked cervical vestibular evoked myogenic potentials (cVEMPs) in normal-hearing healthy young adults. The study also attempted to define the optimal frequency tuning characteristic of NB CE-chirp evoked cVEMPs. Method: cVEMP was performed on 26 young healthy adults using four different NB CE-chirps centered at 500, 1000, 2000, and 4000 Hz. The neck torsion method was applied for electrode placement. To have the acute recording, visual feedback of sternocleidomastoid muscle contraction was provided, and electromyography (EMG) scaling was done. Results: cVEMPs were present for 100% across all frequencies except at 4000 Hz. Amplitudes between each pair of frequencies were significantly different for EMG scaled and unscaled conditions. Frequency tuning was observed at 500 Hz regardless of scaling done. Positive peak 1 of cVEMP (P1) latencies showed no differences between frequencies while both negative peak 1 of cVEMP and the complex of positive peak 1 and negative peak 1 of cVEMP (P1N1) interpeak latency values decreased with increasing frequency. Interaural amplitude asymmetry ratio showed no difference between scaled and unscaled amplitudes. Intraclass correlation revealed a range of test--retest reliability across frequencies. EMG unscaled amplitude were having relatively lower test--retest reliability consistently across frequencies Conclusions: Differences in amplitudes between frequencies with a maximum at 500 Hz can be attributed to the low frequency centered saccular response. No differences in P1 were observed. Yet, N1 latency and P1N1 interpeak latency difference gradually shortened with the decrement in the stimulus duration as the stimulation frequency increased. The lower reliability of EMG unscaled amplitude across frequencies supports the need to use EMG scaling to avoid confounding variables related to muscle contraction. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the localization ability of bilateral cochlear implant (BiCI) users for virtual sound sources produced over a limited loudspeaker arrangement. Design: Ten BiCI users and 10 normal-hearing subjects participated in listening tests in which amplitude- and time-panned virtual sound sources were produced over a limited loudspeaker setup with varying azimuth angles. Three stimuli were utilized: speech, bandpassed pink noise between 20 Hz and 1 kHz, and bandpassed pink noise between 1 kHz and 8 kHz. The data were collected via a twoalternative forced-choice procedure and used to calculate the minimum audible angle (MAA) of each subject, which was subsequently compared to the results of previous studies in which real sound sources were employed. Result: The median MAAs of the amplitude-panned speech, low-frequency pink noise, and high-frequency pink noise stimuli for the BiCI group were calculated to be 20°, 38°, and 12°, respectively. For the time-panned stimuli, the MAAs of the BiCI group for all three stimuli were calculated to be close to the upper limit of the listening test. Conclusions: The computed MAAs of the BiCI group for amplitude-panned speech were marginally larger than BiCI users' previously reported MAAs for real sound sources, whereas their computed MAAs for the time-panned stimuli were significantly larger. Subsequent statistical analysis indicated a statistically significant difference in the performances of the BiCI group in localizing the amplitude-panned sources and the time-panned sources. It follows that timepanning over limited loudspeaker arrangements may not be a useful clinical tool, whereas amplitude-panning utilizing such a setup may be further explored as such. Additionally, a comparison with the patient demographics indicated correlations between the results and the patients' age at time of diagnoses and the time passed between date of diagnosis and their implant surgeries. [ABSTRACT FROM AUTHOR]

Purpose: Simulation is a tool commonly used in the clinical training of students within the health professions fields, such as medicine and nursing. The effectiveness of simulation as a teaching technique has been extensively documented in numerous health care professions; however, little is known about the effectiveness of simulation techniques in audiology education. This study assesses the effectiveness of a simulation activity focused on auditory brainstem response (ABR) testing conducted with students of an applied doctoral program in audiology. Method: Twelve 2nd year audiology graduate students enrolled in the auditory electrophysiology course at Towson University in Fall 2018 participated in this pre--post study. Over a 3-week period, each student (a) received didactic instruction in ABR testing, (b) underwent a presimulation exercise skills assessment, (c) participated in a simulation exercise, and (d) underwent a postsimulation exercise skills assessment. Results: Significant improvements were observed in clinical skill level for the ABR tasks evaluated in terms of both accuracy and efficiency (time in seconds needed to complete the task). The tasks evaluated included skin preparation, identification of scalp electrode placement sites, and scalp electrode placement in a variety of configurations (singleand two-channel arrays, horizontal and vertical electrode montages). Benefits associated with simulation-based instruction varied by clinical skill as well as by student. Conclusions: The data described in this study reinforce the need to incorporate simulation in audiology training programs, especially for complex clinical skills. It also emphasizes the need for additional research that can be useful in the design and implementation of simulation-based exercises. [ABSTRACT FROM AUTHOR]

Objective: The study attempted to track speech-in-noise perception and auditory long latency responses (ALLRs) over a period of hearing aid use in naïve hearing aid users. The primary aim was to investigate the relationship of change in speech-in-noise perception with the change in ALLRs. Method: Thirty adults with mild-to-moderate sensorineural hearing loss (clinical group) and 17 adults with normal hearing (control group) in the age range of 23--60 years participated in the study. Syllable identification in noise (SIN) and ALLRs in noise were measured three times (three sessions) over a period of 2 months of hearing aid use. Results: Results showed a significant increase in SIN and a decrease in the latency of ALLRs in the later sessions compared to the baseline session in the clinical group. However, the changes seen across the three sessions in the control group were not statistically significant. The magnitude of change in ALLRs seen in the clinical group did not significantly correlate with the change in SIN scores seen in them. Conclusions: The study provides evidence for improvements in speech perception in noise and in processing time of auditory cortical areas with hearing aid acclimatization. However, it is important to note that the improvement in ALLRs does not assure improvement in speech perception in noise. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to assess the relationship between the level-dependent function of efferent inhibition and speech perception in noise across different intensities of suppressor and across different signal-to-noise ratios (SNRs) of speech. Method: Twenty-six young normal-hearing adults participated in the study. Contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) was measured for 3 levels of suppressor (40, 50, and 60 dB SPL). Speech identification score (SIS) was measured at 5 ipsilateral SNR conditions (quiet, 0, -5, -10, and -15 dB), with and without contralateral broadband noise at 3 levels (40, 50, and 60 dB SPL). Furthermore, SNR-50 was measured with and without the same 3 levels of contralateral broadband noise. Results: The results showed that the suppression magnitude of TEOAE increased with an increase in suppressor level. However, neither SIS nor SNR-50 was influenced by the contralateral noise. In addition, SIS and SNR-50 did not show significant correlation with contralateral suppression of TEOAEs. This was true at all the SNRs and contralateral noise levels used in the study. Conclusions: The findings suggest that the intensity of noise directly influences medial olivocochlear bundle--mediated efferent inhibition. However, the role of the medial olivocochlear bundle in regulating speech perception in noise needs to be revisited. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to investigate the underlying mechanisms of perceived benefit of hearing aid acclimatization. Specifically, measures in the auditory and cognitive domain were tapped to investigate its relationship with the perceived benefit. Method: Twenty-six individuals with sensorineural hearing loss served as participants for the study. The perceived benefit of hearing aid use was assessed using the Speech, Spatial and Qualities of Hearing Scale (SSQ; Gatehouse & Noble, 2004). Signal-to-noise ratio-50 (SNR-50) and acceptable noise levels were the measures in auditory domain, whereas working memory and listening effort (LE) were the measures in cognitive domain. All the measures were tracked over a span of 2 months of hearing aid use to determine the benefits of hearing aid acclimatization. Results: The SSQ showed improvements from baseline to 2nd month of hearing aid use. The mean improvement in the SNR-50 scores was 3.19 dB from the baseline. Acceptable noise levels and working memory did not change with hearing aid use. LE showed improvements in quiet but not in noise. The improvements in the SSQ were found to relate with the improvements in SNR-50. Conclusions: The study indicated a significant perceived benefit with hearing aid acclimatization, and the underlying mechanism appears to be the signal-to-noise ratio gain. The findings of LE indicated reduced LE, thereby suggesting lesser cognitive load with hearing aid acclimatization. In addition, the individuals who performed poorer in the baseline measurement showed greater perceived benefit with hearing aid acclimatization. [ABSTRACT FROM AUTHOR]

Purpose: This article investigates the possible connections between the level of chronic stress and success of steroid therapy in patients with sudden sensorineural hearing loss (SSNHL). Method: A single-center, retrospective, longitudinal cohort studyon55patientsinatertiary referral otology center was examined. Patients diagnosed with SSNHL between 2014 and 2017 were asked to complete a Measure of Perceived Stress (Brajac, Tkalcic, Dragojević,&Gruber, 2003) questionnaire. Inclusion criteria were patients > 18 years of age, SSNHL diagnosed within 4 previous weeks, completed steroid treatment, and complete documentation. Results: There were 30 patients (55%) that showed significant improvement in their pure-tone audiogram (PTA) hearing threshold average (≥ 15 dB) after steroid treatment. Two- step cluster analysis identified 3 clusters based on average PTA hearing threshold recovery and average Measure of Perceived Stress scores. The difference between pretreatment and posttreatment hearing levels was significantly higher in the cluster with moderate stress compared to clusters with mild and high stress levels (Kruskal--Wallis test, Friedman test, p < .001). There were no significant differences in average PTA hearing threshold recovery after steroid therapy between groups of patients with mild and severe stress. Conclusion: Patients with moderate stress levels show significantly better results after steroid treatment for SSNHL than patients with low or high stress levels. [ABSTRACT FROM AUTHOR]

Purpose: The field of neuromodulation is currently seeking to treat a wide range of disorders with various types of invasive devices. In recent years, several preclinical trials and case reports in humans have been published on their potential for chronic tinnitus. However, studies to obtain insight into patients' willingness to undergo these treatments are scarce. The aim of this survey study was to find out whether tinnitus patients are willing to undergo invasive neuromodulation when taking its risks, costs, and potential benefits into account. Method: A Visual Analog Scale (VAS, 0-10) was used to measure the outcome. Spearman's rank-order correlation coefficients were computed to determine the correlation between patient characteristics and acceptance rates. Results: Around one fifth of the patients were reasonably willing to undergo invasive treatment (VAS 5--7), and around one fifth were fully willing to do so (VAS 8--10). Hearing aids, used as a control, were accepted most, followed by cochlear implantation, deep brain stimulation, and cortical stimulation. Acceptance rates were slightly higher when the chance of cure was higher. Patients with a history of attempted treatments were more eager than others to find a new treatment for tinnitus. Conclusions: A considerable proportion of patients with tinnitus would accept a variety of invasive treatments despite the associated risks or costs. When clinical neuromodulatory studies for tinnitus are to be performed, particular attention should be given to obtaining informed consent, including explaining the potential risks and providing a realistic outcome expectation. [ABSTRACT FROM AUTHOR]