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We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p <.05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p >.05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss. [ABSTRACT FROM AUTHOR]

Introduction "Good hearing" (DoDI 6030.03 6.5&6.6) is a combat multiplier, critical to service members' lethality and survivability on the battlefield. Exposure to an explosive blast or high-intensity continuous noise is common in operational settings with the potential to compromise both hearing and vestibular health and jeopardize safety and high-level mission performance. The Joint Trauma System Acoustic Trauma Clinical Practice Guideline was published in 2018, providing recommendations for the assessment and treatment of aural blast injuries and acoustic trauma in the forward deployed environment. Combat care capabilities responsive to current threat environments emphasize prolonged casualty care. Despite recommendations, auditory system health has not been assessed routinely or in its entirety on the battlefield. This is due primarily to the large footprint of an audiometric booth and to the heavy logistical burden of providing high-quality, comprehensive auditory system (including vestibular) examinations in the combat environment. Materials and Methods The Defense Health Agency Hearing Center of Excellence has completed a Doctrine, Organization, Training, Materiel, Leadership & Education, Personnel, Facilities, and Policy (DOTmLPF-P) analysis of battlefield auditory system assessment and treatment, using 67 existing DoD documents and artifacts related to operational medicine. Results Our analysis found that acoustic trauma is generally not addressed in any of the DOTmLPF-P domains. We recommend that auditory system assessment and treatment be incorporated across the continuum of care on the battlefield. This should be addressed through Prolonged Field Care and Tactical Combat Casualty Care guidance and in all Tactical Combat Casualty Care training programs. Equipment sets should be modified to include boothless technology and associated materiel for auditory system assessment. Policy and Doctrine changes would be required to mandate and support the implementation of these services. Uniformed audiologists should be added to the organizational structure at role 3 or higher to provide direct patient care; consult with other health care providers and commanders; develop and support enforcement of noise hazard guidelines; track hearing readiness; and, when necessary, provide specialized hearing protection devices that can compensate for hearing loss. Conclusions These recommendations aim to help the DoD bring about necessary assessments and interventions for acoustic trauma so that service members can have better hearing outcomes and maintain critical auditory system function on the battlefield. [ABSTRACT FROM AUTHOR]

Objective: Although corticosteroids and other treatments for idiopathic sudden sensorineural hearing loss (ISSNHL) have been described, understanding its prognosis without intervention provides valuable information for patient management. The objective of this study is to provide a comprehensive, quantitative statistical analysis of the natural history of untreated idiopathic sudden sensorineural hearing loss (ISSNHL). Study Type and Design: A systematic review and meta‐analyses. Methods: Two independent searches of PubMed, Scopus, Web of Science, and Cochrane Library databases up to June 30, 2022, were performed. Adults with idiopathic sudden sensorineural hearing loss who received placebo or were untreated and had audiometric outcome measures in all study types were reviewed. These data indicative of the natural history of ISSNHL were analyzed, as were study characteristics related to risk of bias. Heterogeneity as assessed via I2 and random effects analyses were performed. Results: Six studies meeting the inclusion criteria yielded 319 untreated patients whose natural history could be assessed. Heterogeneity among studies was moderate, with a variety of reported outcomes. A hearing improvement of at least 30 dB HL was observed in 36% (95% CI 0.28–0.44) of untreated patients, and of at least 10 dB HL was observed in 70% (95% CI 0.57–0.82) of untreated patients at 3 months. The mean hearing gain among untreated patients was 24.0 dB HL (95% CI 2.65–45.37) at 2–3 months. Conclusions: The observed natural history of ISSNHL suggests that patients can regain some hearing without active treatment. In the absence of future studies collecting prospective natural history data from untreated or placebo‐treated ISSNHL patients, the data presented here provide the best available historical control data for reconsideration of results in past ISSNHL studies, as well as a roadmap for design and interpretation of future ISSNHL treatment clinical trials. Furthermore, knowing there is a statistically significant mean hearing gain of 24.0 dB HL in the untreated/placebo group provides an ethical basis for future placebo study of ISSNHL. The current status on ISSNHL management calls for a multi‐institutional, randomized, double‐blind placebo‐controlled trial with validated outcome measures to provide science‐based treatment guidance. Laryngoscope, 134:S1–S15, 2024 [ABSTRACT FROM AUTHOR]

Objective: To examine whether the responsiveness of young children to simple sounds was associated with entertainment screen time (EST), opportunities for social interaction, and social and communication skills. Design: Parents completed a questionnaire covering, for years one and two, the number of times the child met with other children; the number of words the child spoke; and the daily amount of EST. Social, attention and communication skills were assessed. Study sample: Participants were 118 children, aged 15 to 46 months. They were initially assessed behaviourally using simple sounds. Children who responded to such sounds were denoted the Responsive group. Children who did not were assessed using familiar songs and denoted the Unresponsive group. Results: The two groups did not differ significantly in mean age or the number of opportunities to meet other children. The Unresponsive group had significantly fewer words than the Responsive group at 12 and 24 months and had significantly higher EST than the Responsive group for years 1 and 2. The Unresponsive group showed lower social, attention and communication skills than the Responsive group. Conclusions: High EST was associated with poorer auditory and social skills. Hence, it may be wise to limit the EST of young children. [ABSTRACT FROM AUTHOR]

Objective: Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area. Design: Aboriginal infants enrolled in the Djaalinj Waakinj prospective cohort study had ear health screenings at ages 2-4, 6-8 and 12-18 months and audiological assessment at ∼12 months of age. Sociodemographic, environmental characteristics, otoscopy, otoacoustic emissions, tympanometry and visual reinforcement audiometry data were collected. Study Sample: 125 infants were enrolled in the study; 67 completed audiological assessment, 62, 54, and 58 of whom attended ear screenings at 2-4, 6-8 and 12-18 months. Results: Of the children that attended the audiological assessment, 36.5%, 50% and 64.3% of infants had otitis media (OM) at 2-4, 6-8 and 12-18 months. Using a 10 dB correction factor, 44.8% of infants had hearing loss (HL) (≥ 25 dB HL) at ∼ 12 months of age. More males (X2=5.4 (1df, p = 0.02)) and infants with OM at audiological assessment (X2=5.8 (1df, p = 0.02)) had HL. More infants that used a pacifier at 12-18 months of age had HL (X2=4.7 (1df, p = 0.03)). Conclusion: Aboriginal infants in an urban area have high rates of HL and OM, which requires early surveillance and timely treatment to reduce the medical and developmental impacts of OM and HL. [ABSTRACT FROM AUTHOR]

Objective: Hearing disorders are common among music professionals, as they are frequently exposed to sound levels exceeding 100 dB(A). By assessing auditory fatigue, situations that are deleterious for hearing could be identified, allowing the deployment of preventive measures before permanent impairment occurs. However, little is known about the factors contributing to auditory fatigue. The objective is to determine the exposure parameters most influencing auditory fatigue during occupational exposure to amplified music. Design: Auditory fatigue was defined as variations of both pure tone auditory (ΔPTA) and efferent reflex thresholds (ΔER) during the workday. Noise exposure was monitored and information on the volunteers was gathered using a questionnaire. Study sample: The population consisted of 43 adult volunteers exposed to amplified music (sound, light or stage technicians, security agents, barmen) and 24 unexposed administrative agents. Results: ΔPTA and ΔER were positively correlated with the energy of noise exposure and its stability over time, i.e a steady noise tends to create more auditory fatigue. Conclusion: In addition to a global decrease of music levels and a systematic use of hearing protection, our results advocate for the provision of quiet periods within noise exposures as they reduce auditory fatigue accumulation and long-term risks for hearing. [ABSTRACT FROM AUTHOR]

Prevalence of hearing loss in children with autism spectrum disorder (ASD) is uncertain, as it is more challenging to assess hearing function in children with developmental difficulties (DD). We aimed to determine the prevalence and profiles of hearing loss in preschool children with ASD in a Southeast-Asian population who passed newborn hearing screening. A retrospective study of preschool children with DD (ASD, Global Developmental Delay (GDD), and Speech and Language Delay (SLD)) attending the Child Development Unit (CDU) at our hospital was performed. Three hundred and thirty-three children (ASD: n = 129; GDD: n = 110; and SLD: n = 94) underwent hearing assessments. Of these, 10.8% of children (n = 36, comprising 15 with ASD, 12 with GDD and 9 with SLD) had confirmed hearing loss. Hearing loss was predominantly bilateral in children with ASD and GDD; in those with SLD, unilateral and bilateral hearing loss were equally common. Conductive hearing loss occurred as frequently as sensorineural hearing loss in children with ASD and SLD, but was the dominant subtype in those with GDD. Moderate to severe hearing loss (n = 2) was noted only in children with ASD. Children with ASD and GDD required significantly more audiology visits and procedures to obtain conclusive hearing test results, compared to those with SLD. The need to identify hearing loss and monitor for resolution is particularly important in vulnerable populations with communication deficits, such as in those with ASD. [ABSTRACT FROM AUTHOR]

Objectives: Pendred syndrome, an autosomal recessive disorder, is often associated with pathogenic variants of the SLC26A4 gene that encodes the pendrin protein. Given its autosomal recessive inheritance, tracing the family history and screening siblings become crucial once a diagnosis of Pendred syndrome is confirmed. This case report aims to underscore the variability in inner ear morphology within a family diagnosed with Pendred syndrome, all carrying the same SLC26A4 gene mutation. Methods: A chart review and a review of the literature. Results: We present a family of 4, all of whom possess sensorineural hearing loss due to the same homozygous SLC26A4 variant c.919-2A>G. Intriguingly, clinical manifestations, especially inner ear deformities, displayed variability among family members. Notably, 1 family member exhibited a normal cochleovestibular structure morphology, which was rarely reported in the literature. Conclusions: This report highlights the significance of genetic testing and familial consultation when a proband exhibits typical Pendred syndrome symptoms. It also underscores that the inner ear morphology can exhibit variability among family members, even with the same homozygous SLC26A4 variant. [ABSTRACT FROM AUTHOR]

To improve diagnostic precision in pediatric vertigo, particularly in Vestibular Migraine of Childhood (VMC), probable VMC (pVMC), Recurrent Vertigo of Childhood (RVC), and unspecified categories, by delineating clinical characteristics and prevalence to refine diagnostics and treatments. Retrospective analysis of 102 pediatric patients (five to 18 years; 46 females, 56 males) at the Dizziness Center of the Otolaryngology Department in a tertiary-level hospital from January 2019 to December 2023. Patients were classified into VMC, pVMC, RVC, and indeterminate groups. Evaluations included audiometry and vestibular tests (video head impulse test [vHIT] or caloric testing), conducted in the audiology unit and vestibular testing laboratory. Data were analyzed using IBM SPSS 20.0. Diagnoses were 8.8% VMC, 31.4% pVMC, 51.0% RVC, and 8.8% indeterminate. Nausea and vomiting were common in VMC and pVMC; cochlear symptoms like tinnitus and hearing loss predominated in VMC. Although vestibular testing showed no significant group differences, VMC had more vHIT abnormalities and RVC had more caloric test anomalies. This study highlights the need for comprehensive diagnostics in pediatric vestibular disorders, revealing unique and overlapping traits across VMC, pVMC, and RVC. Insights call for further research to refine diagnostic criteria and improve treatment methods. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of strabismus surgery on dynamic balance by using computerized dynamic posturography in children with strabismus. Methods: This study was designed as a prospective observational study. Hearing tests and complete ophthalmological examinations were performed for all subjects. Patients with moderate and severe amblyopia, hearing loss at any level, and/or any suspicion of balance impairment were excluded from the study. Postural stability evaluation was performed by computerized dynamic posturography including sensory organization test, adaptation test, and rhythmic weight shift test. All tests were applied preoperatively and in the postoperative 1st and 3rd months, respectively. Results: Fifteen female and twelve male pre-adolescents aged between 7 and 12 (9.67 ± 1.62 years) were included in the current study. In the sensory organization test, the preoperative visual ratio percentages (73.19 ± 14.95%) improved statistically significantly at the postoperative 1st and 3rd months (78.59 ± 16.21% and 81.44 ± 14.18; p =.026, p =.021, respectively). The preoperative toes up (110.66 ± 33,48) and toes down (81.46 ± 28.36) adaptation tests improved statistically significantly in the postoperative 3rd month (88.74 ± 20.94 and 63.36 ± 16.03; p <.001, p =.001, respectively). In the Rhythmic Weight Shift test, the postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the preoperative directional control (forward-backward) value (67.76 ± 11.38%) (p =.011). The postoperative 3rd-month directional control (forward-backward) value (74.25 ± 11.51%) was statistically significantly higher compared to the postoperative 1st-month directional control (forward-backward) value (68.43 ± 14.00%) (p =.028). Conclusion: Surgical treatment resulted in an improvement in the maintenance of dynamic balance in children with strabismus. [ABSTRACT FROM AUTHOR]

This study aimed to determine knowledge, attitude, and practices towards Noise-Induced Hearing Loss among maintenance and administration workers in selected health facilities in the Modimolle-Mookgopong Municipality. Non-probability convenient sampling was used to select 250 participants. Maintenance workers were populated within the age range of 26–35 years, being more than administrative personnel (COR 1.59, CI 0.8–3.16). Maintenance workers showed more knowledge of noise being an unwanted sound (COR 1.04, CI 0.29–3.73), an ear infection (COR 4.65, CI 1.48–14.58) and poor hearing of speech as a sign of hearing loss (AOR 0.25, CI 0.07–0.86). Thirty-four percent (34%) of maintenance workers believed that ear screening and assessments are important while 17.9% believed not to be important. Forty-eight percent (58%) of maintenance workers suggested that they could not use hearing protectors effectively without training while 13.7% suggested training is needed. [ABSTRACT FROM AUTHOR]

Introduction: Pathway innovation using smartphone otoscopy and tablet‐based audiometry technologies to deliver ear and hearing services via trained audiologists may improve efficiency of the service. An ENT‐integrated‐community‐ear service (ENTICES—combining community audiology management, remote ENT review and novel technologies) was piloted. We aimed to assess the efficiency and safety of ENTICES. Method: ENTICES was a community‐based and audiologist‐led pathway. Patients with otological symptoms were self‐referred to this service. Smartphone otoscopy and tablet‐based audiograms were performed. Two otologists reviewed all decisions made in the community by audiologists based on video‐otoscopy, hearing tests and chart reviews. Data on the first 50 consecutive new patients attending either consultant‐led hospital otology clinics (HOC), audiologist‐led hospital advanced audiology diagnostics (AAD) or ENTICES clinics were collected between 1 August 2021 and 31 December 2021. Data were collected through chart reviews and questionnaires to compare the three pathways with respect to efficiency, patient satisfaction, technology utility and safety. Results: No audiology‐led ENTICES decisions were amended by hospital otologists following remote review. Remote review of video‐otoscopy with history was sufficient for a diagnosis in 80% of cases. Adding hearing tests and standardised history increased the diagnostic yield to 98%. Patient satisfaction scores showed 100% service recommendation. The cost per patient, per visit, was £83.36, £99.07 and £69.72 for AAD, HOC or ENTICES, respectively. Conclusion: ENTICES provides a safe ear and hearing service that patients rated highly. Thirty‐two per cent of hospital otology patients were eligible for this service. For those patients, ENTICES is 20% more cost‐effective and can reduce the number of clinic visits by up to 60% compared with HOC. [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]

Objective: Pure tone audiometry has played a critical role in audiology as the initial diagnostic tool, offering vital insights for subsequent analyses. This study aims to develop a robust deep learning framework capable of accurately classifying audiograms across various commonly encountered tasks. Design, Setting, and Participants: This single‐centre retrospective study was conducted in accordance with the STROBE guidelines. A total of 12 518 audiograms were collected from 6259 patients aged between 4 and 96 years, who underwent pure tone audiometry testing between February 2018 and April 2022 at Tongji Hospital, Tongji Medical College, Wuhan, China. Three experienced audiologists independently annotated the audiograms, labelling the hearing loss in degrees, types and configurations of each audiogram. Main Outcome Measures: A deep learning framework was developed and utilised to classify audiograms across three tasks: determining the degrees of hearing loss, identifying the types of hearing loss, and categorising the configurations of audiograms. The classification performance was evaluated using four commonly used metrics: accuracy, precision, recall and F1‐score. Results: The deep learning method consistently outperformed alternative methods, including K‐Nearest Neighbors, ExtraTrees, Random Forest, XGBoost, LightGBM, CatBoost and FastAI Net, across all three tasks. It achieved the highest accuracy rates, ranging from 96.75% to 99.85%. Precision values fell within the range of 88.93% to 98.41%, while recall values spanned from 89.25% to 98.38%. The F1‐score also exhibited strong performance, ranging from 88.99% to 98.39%. Conclusions: This study demonstrated that a deep learning approach could accurately classify audiograms into their respective categories and could contribute to assisting doctors, particularly those lacking audiology expertise or experience, in better interpreting pure tone audiograms, enhancing diagnostic accuracy in primary care settings, and reducing the misdiagnosis rate of hearing conditions. In scenarios involving large‐scale audiological data, the automated classification system could be used as a research tool to efficiently provide a comprehensive overview and statistical analysis. In the era of mobile audiometry, our deep learning framework can also help patients quickly and reliably understand their self‐tested audiograms, potentially encouraging timely consultations with audiologists for further evaluation and intervention. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsTo assess the feasibility of implementing a school entry hearing screening programme in the South-East District, Botswana.A feasibility study design was used. Trained screeners conducted smartphone-based pure tone audiometry screening at 25 dB HL, at 1, 2, and 4 kHz using calibrated headphones. Learners with “refer” results after an immediate rescreen were referred and scheduled for diagnostic hearing assessment at the local hospital. Attendance at diagnostic appointments was encouraged through multiple contacts with the families.The study participants were 403 Grade 1 learners from eight public primary schools.The overall referral rate for diagnostic hearing assessment was 4.7%, with a referral uptake rate of 90%. The sensitivity and specificity of the hearing screening protocol were 93.3% and 86.4%, respectively. The positive and negative predictive values were 82.4% and 95%, respectively. The average cost per learner screened was US$ 10.75.School entry hearing screening programmes can be successfully implemented in the South-East District, Botswana. Lessons learnt from this study can potentially guide phased implementation of school hearing screening programmes in other districts. [ABSTRACT FROM AUTHOR]

Background: Migraine disease is a chronic headache disorder characterized by recurrent attacks. Migraine and vestibular disorders are common associations. The exact pathophysiology is still unknown. Objectives: To study the results of vHIT and VNG in dizzy migraineurs. Methods: This is a case-control study that included 140 subjects 70 of them were migraine patients with vestibular symptoms, while the other 70 were a control group of healthy subjects matched in age. A full history with pure tone audiometry and tympanogram for hearing evaluation was done for both groups then videonystagmography and the video head impulse tests were done. Results: The vHIT results showed that there were no significant differences among control and study groups regarding the VOR gain and gain asymmetry with no corrective saccades recorded in patients or control groups that denote the VOR is intact. The VNG test revealed in OPK and saccade tests that there was a significant difference between the control and the study groups. A positive weak correlation between vHIT and caloric test results in the left lateral and posterior canal gain in the study group. Conclusion: The migraine disease with vestibular symptoms does not affect the VOR gain in vHIT and affects the oculomotor tests in VNG. [ABSTRACT FROM AUTHOR]

Active middle ear implants (AMEI) amplify mechanical vibrations in the middle ear and transmit them to the cochlea. The AMEI includes a floating mass transducer (FMT) that can be placed using two different surgical approaches: "oval window (OW) vibroplasty" and "round window (RW) vibroplasty." The OW and RW are windows located on the cochlea. Normally, sound stimulus is transmitted from the middle ear to cochlea via the OW. RW vibroplasty has been suggested as an alternative method due to the difficulty of applying OW vibroplasty in patients with ossicle dysfunction. Several reports compare the advantages of each approach through pre and postoperative hearing tests. However, quantitatively assessing the treatment effect is challenging due to individual differences in pathologies. This study investigates the vibration transmission efficiency of each surgical approach using a finite-element model of the human cochlea. Vibration of the basilar membrane (BM) of the cochlea is simulated by applying the stimulus through the OW or RW. Pathological conditions, such as impaired stapes mobility, are simulated by increasing the stiffness of the stapedial annular ligament. RW closure due to chronic middle ear diseases is a common clinical occurrence and is simulated by increasing the stiffness of the RW membrane in the model. The results show that the vibration amplitude of the BM is larger when the stimulus is applied to the RW compared to the OW, except for cases of RW membrane ossification. The difference in these amplitudes is particularly significant when stapedial mobility is limited. These results suggest that RW vibroplasty would be advantageous, especially in cases of accompanying stapedial mobility impairment. Additionally, it is suggested that transitioning to OW vibroplasty could still ensure a sufficient level of vibratory transmission efficiency when placing the FMT on the RW membrane is di cult due to anatomical problems in the tympanic cavity or confirmed severe pathological conditions around the RW. [ABSTRACT FROM AUTHOR]

Indigenous peoples of Aotearoa New Zealand, Māori, are often excluded and underserved by hearing health services that often neglect their cultural values and needs. In response to this, we aimed to advance the delivery of culturally appropriate services with Māori clients through the validation of a te reo Māori hearing screening test. A He Awa Whiria: Braided rivers framework was applied to weave Māori knowledge and cultural values into this audiological research and to support the collaboration of Māori and non-Māori researchers through a Kaupapa Māori approach stream. While the validation of the screening test was interrupted due to COVID-19, we discuss in detail the approach stream used in this study. Together the approach and validation streams form the foundation of an ongoing research initiative aimed at addressing Western biomedical approach limitations, expanding the hearing health sector's knowledge base to deliver culturally responsive care, and in a small way contributing to the revitalisation of te reo Māori.Glossary of Māori words: Ahitereiria ki te Hauāuru: Western Australia; atua: ancestor with continuing influence; Aotearoa: North Island of New Zealand - now used as the Māori word for New Zealand; hapū: sub-tribal, clans, wider whānau descent or political units; hongi: traditional Māori greeting; He Awa Whiria: braided rivers approach; hui: meeting; ia: Te reo Māori pronoun for everyone; iwi: tribe; kai: food; Kai Tahu/Ngai Tahu: tribal group of the South Island; kanohi kitea: the seen face; kanohi ki te kanohi: face-to-face; karakia: incantation, chant, thought, or prayer; kaumātua: Māori elder/s; kaupapa: topic, policy, matter of discussion; Kaupapa Māori: a philosophical approach using Māori knowledge and values; kete: woven basket/s; Kohanga Reo: Māori language preschool; kōrero: narratives and prose; koringo-tangi-roa: the wooden flute or trumpet of Ngongo; kūmara: wweet potato; Kura Kaupapa: Māori language immersion schools; kupu: word, vocabulary; manaakitanga: the process of showing respect, generosity and care for others; Māori: Indigenous people of Aotearoa New Zealand; marae: a significant Māori community complex of buildings; mātauranga Māori: Indigenous Māori knowledge; Ngā Rauru: an iwi of Taranaki; Ngāpuhi: a tribal group situated in the top of the North Island; Ngāti Hau: people of the Whanganui River; Ngāti Porou: a tribal group of the East Coast of the North Island; Ngāti Whātua: tribal group between the Hokianga Harbour and Tāmaki; Ōtautahi: traditional name known now as Christchurch; Pākehā: New Zealander with European descent, non-Māori; Papatūānuku: Earth mother; pihoi: inattentively deaf; pūwharawhara: deaf; Rakinui/Ranginui: Sky father; Rehua: a deaf atua associated with kindness, a child of Pāpātuanuku and Rakinui; tāhorehore: deaf as if the ears were cropped; Takaroa/Tangaroa: an atua of the sea; Taki-ao-terangi: daughter of Rehua; Tāmaki: Auckland; Tāne-tūturi: a deaf child of Ranginui and Papatūānuku; Tangata Tiriti: people of Te Tiriti, referring to all non-Māori citizens and residents of Aotearoa; tangata whenua: people of the land, Indigenous peoples, local people, hosts; taonga: treasure of social or cultural value; tapu: sacred, spiritual restriction containing a strong imposition of rules and prohibitions; taringa kōhatu: deaf, stubborn; taringa muhu kai: ear listening for food - a person whose only concern is when food is served; taringa puta iti: little ear orifice, inattentive; taringa turi: deaf; teina: young, less skilled learner; te Ao Māori: the Māori world; te reo Māori (te reo): the Māori language, Indigenous language of Aotearoa; Te Tiriti o Waitangi: Signed in 1840 this is the Māori language version of an agreement between two internationally recognised sovereign nations, Māori, as tāngata whenua, and the British Crown; Te Waipounamu: the South Island of Aotearoa New Zealand; Te Whakamātautau Whakarongo o Aotearoa: Te Reo Māori Digit Triplet Test, TRMDTT; tikanga Māori: Māori customs, procedures, protocols, practices, system of values, the Māori way; tīpuna: ancestors; tohunga: priest, practitioner, expert; tuakana: mentors; turi: deaf; turikere: deafened; waiata: songs and chants; wairuatanga: spiritual well-being; Waitaha: traditional name for region known as Canterbury; wānanga: to meet and discuss, Māori learning, educational forum; whakamā: shame, embarrassment, guilt; whakapapa: To place in layers, to recite genealogies, lineage; whakarongo: an intransitive verb that can mean to listen but may also be used to ready the senses such as to smell, touch or feel; whakataukī: proverb, significant saying; whakawhanaungatanga: an indigenous process of creating relational connection; whānau: immediate and extended family and friends. [ABSTRACT FROM AUTHOR]

Introduction: Sensorimotor adaptation has often been studied in the visual modality through the Prism Adaptation (PA) paradigm. In this paradigm, a lateral shift in visual pointing was found after wearing prismatic goggles. An effect of PA has sometimes been observed on hearing, in favor of a cross-modality recalibration. However, no study has ever shown if a biased auditory-motor adaptation could induce this lateral shift, which appears essential to a better understanding of the mechanisms of auditory adaptation. The present study aimed at inducing an auditory prism-like effect. Methods: Sixty healthy young adults underwent a session of active audio-proprioceptive training in immersive virtual reality based on Head Related Transfer Functions (HRTF). This training consisted of a game in which the hand-held controller emitted sounds either at its actual position in a control group or at 10° or 20° to the right of its actual position in two experimental groups. Sound localization was assessed before and after the training. Results: The difference between both localization tests was significantly different between the three groups. As expected, the difference was significantly leftward for the group with a 20° deviation compared to the control group. However, this effect is due to a significant rightward deviation in the control group whereas no significant difference between localization tests emerged in the two experimental groups, suggesting that other factors such as fatigue may have cumulated with the training after-effect. Discussion: More studies are needed to determine which angle of deviation and which number of sessions of this audio-proprioceptive training are required to obtain the best after-effect. Although the coupling of hearing and vision in PA still needs to be studied, adding spatial hearing to PA programs could be a promising way to reinforce after-effects and optimize their benefits. [ABSTRACT FROM AUTHOR]

Introduction: The Norwegian Directorate of Health approved the Norwegian Hearing Register for Children in 2022. The main objective of the register is to improve the quality of treatment for children with permanent hearing loss, by measures, follow-ups and monitoring the quality and results of the health care system. Methods: Inclusion criteria are children who do not pass universal newborn hearing screening and/or children with permanent hearing loss <18 years of age. Hearing loss is defined as pure-tone audiometry threshold of (PTA4)> 20 dB in at least one ear. Data are registered at the Ear, Nose and Throat departments at inclusion and at follow-ups at the age of 3, 6, 10, and 15 years. The register collects information about the child within a holistic perspective. The key elements of the register are (a) data concerning newborn hearing screening; (b) data concerning hearing, medical information, hearing amplification and intervention (c) patient reported outcome measures registered by caregivers using three questionnaires; Pediatric Quality of Life Inventory, Strengths and Difficulties Questionnaire and Parents' Evaluation of Aural/Oral Performance of Children. Results: The register has established four quality indicators regarding newborn hearing screening and early intervention (a) the rate of false positive neonatal screens; (b) testing for congenital cytomegalovirus within 3 weeks of age for children who do not pass newborn hearing screening; (c) audiological evaluation to confirm the hearing status no later than 3 months of age and (d) initiated intervention within 3 months after confirmation of hearing status. Discussion: The register will include the total population of hearing impaired children over long time periods. Thus, the register enables each hospital to monitor their quality indicator scores continuously and compare them with national levels in real time. This facilitates and accelerates identification of improvement areas in the hospitals and will be an important contributor for quality improvement in NHS, diagnostics and hearing intervention for children in Norway. In addition, data from the register will be a unique source for research, and study designs with a long follow-up time can be applied. [ABSTRACT FROM AUTHOR]

Hearing loss is a major public health problem. In 2050, it could affect 2.5 billion people. It has therefore become necessary to prevent and diagnose them as early and as widely as possible. However, the costs of clinical equipment dedicated to the functional exploration of hearing remain high and hamper their distribution, while the technologies used are relatively basic. For example, the gold-standard pure-tone audiometry (PTA) essentially consists of emitting pure sounds. In addition, clinical audiometers are generally limited to PTA or few audiological tests, while hearing loss induce multiple functional deficits. Here, we present the Aupiometer, a low-cost audiometer implemented on a modular open-source system based on Raspberry Pi, and which integrates the entire technical framework necessary to carry out audiological measurements. Several hearing tests are already implemented (e.g. PTA, speech audiometry, questionnaires), while the clinical validity of the Aupiometer was verified on a panel of participants (N = 16) for an automated test of standard and extended high-frequency PTA, from 0.125 to 16 kHz, in comparison with a clinical audiometer. For this comparison between the two devices and over this wide frequency range, the difference is evaluated as less than ±10 dB for a 90% confidence interval, of the same order of magnitude as on test-retest differences on a single device. The interest of this device also extends to academic research as it should encourage the prototyping of innovative hearing tests by the community, in order to better understand the diversity of hearing problems in the population. [ABSTRACT FROM AUTHOR]

Hearing loss is common among Veterans, and extensive hearing care resources are prioritized within the Veterans Administration (VA). Severe hearing loss poses unique communication challenges with speech understanding that may not be overcome with amplification. We analyzed data from the VA Audiometric Repository between 2005 and 2017 and the relationship between hearing loss severity with speech recognition scores. We hypothesized that a significant subset of Veterans with severe or worse hearing loss would have poor unaided speech perception outcomes even with adequate audibility. Sociodemographic characteristics and comorbidities were compiled using electronic medical records as was self-report measures of hearing disability. We identified a cohort of 137,500 unique Veterans with 232,789 audiograms demonstrating bilateral severe or worse hearing loss (four-frequency PTA > 70 dB HL). The median (IQR; range) age of Veterans at their first audiogram with severe or worse hearing loss was 81 years (74 to 87; 21–90+), and a majority were male (136,087 [99%]) and non-Hispanic white (107,798 [78.4%]). Among those with bilateral severe or worse hearing loss, 41,901 (30.5%) also had poor speech recognition scores (<50% words), with greater hearing loss severity correlating with worse speech perception. We observed variability in speech perception abilities in those with moderate-severe and greater levels of hearing loss who may derive limited benefit from amplification. Veterans with communication challenges may warrant alternative approaches and treatment strategies such as cochlear implants to support communication needs. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignResultsConclusionsDevelopments in smartphone technology and the COVID-19 pandemic have highlighted the feasibility and need for remote, but reliable hearing tests. Previous studies used remote testing but did not directly compare results in the same listeners with standard lab or clinic testing. This study investigated validity and reliability of remote, self-administered digits-in-noise (remote-DIN) compared with lab-based, supervised (lab-DIN) testing. Predictive validity was further examined in relation to a commonly used self-report, Speech, Spatial, and Qualities of Hearing (SSQ-12), and lab-based, pure tone audiometry.DIN speech reception thresholds (SRTs) of adults (18-64 y/o) with normal hearing (NH, N = 16) and hearing loss (HL, N = 18), were measured using English-language digits (0-9), binaurally presented as triplets in one of four speech-shaped noise maskers (broadband, low-pass filtered at 2, 4, 8 kHz) and two phases (diotic, antiphasic).High, significant intraclass correlation coefficients indicated strong internal consistency of remote-DIN SRTs, which also correlated significantly with lab-DIN SRTs. There was no significant mean difference between remote- and lab-DIN on any tests. NH listeners had significantly higher SSQ scores and remote- and lab-DIN SRTs than listeners with HL. All versions of remote-DIN SRTs correlated significantly with pure-tone-average (PTA), with the 2-kHz filtered test being the best predictor, explaining 50% of the variance in PTA. SSQ total score also significantly and independently predicted PTA (17% of variance) and all test versions of the remote-DIN, except the antiphasic BB test.This study underscores the effectiveness of remote DIN test and SSQ-12 in assessing auditory function. These findings suggest the potential for wider access to reliable hearing assessment, particularly in remote or underserved communities. [ABSTRACT FROM AUTHOR]

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals' auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH (n = 20) and OHL (n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing. [ABSTRACT FROM AUTHOR]

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

To validate measurement of predicted earmold wideband real-ear-to-coupler difference (wRECD) using an integrated pressure level (IPL) calibrated transducer and the incorporation of an acoustically measured tubing length correction. Unilateral earmold SPL wRECD using varied hearing aid tubing length and the proposed predicted earmold IPL wRECD measurement procedure were completed on all participants and compared. 22 normal hearing adults with normal middle ear status were recruited. There were no clinically significant differences between probe-microphone and predicted earmold IPL wRECD measurements between 500 and 2500 Hz. Above 5000 Hz, the predicted earmold IPL wRECD exceeded earmold SPL wRECDs due to lack of standing wave interference. Test-retest reliability of IPL wRECD measurement exceeded the reliability of earmold SPL wRECD measurement across all assessed frequencies, with the greatest improvements in the high frequencies. The acoustically measured tubing length correction largely accounted for acoustic effects of the participant's earmold. IPL-based measurements provide a promising alternative to probe-microphone earmold wRECD procedures. Predicted earmold IPL wRECD is measured without probe-microphone placement, agrees well with earmold SPL wRECDs and is expected to extend the valid bandwidth of wRECD measurement. [ABSTRACT FROM AUTHOR]

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

To assess the utility of targeted surveillance for the identification of moderate to profound PCHI in babies who pass newborn hearing screening in England and have risk factors. Retrospective analysis. A total of 3,957,891 children born 01/04/2012–31/03/2018 in England. A total of 7148 PCHI cases were identified (1.81 per 1,000 babies). 6,707 followed an immediate referral from the screen (1 per 16 referrals), 51 followed targeted surveillance referral (1 per 540 referrals) and 390 without a referral. Audiology uptake was higher following an immediate referral (96.7% overall, 77.2% within NHSP-defined timescales) than following targeted surveillance (63.8% overall, 51.1% within 52 weeks of birth). The screening was 94.5% sensitive overall, with similar sensitivities for each of the risk factors. General linearised logistic regression models identified syndrome as the risk factor with the highest odds ratio (14.08 for all babies, 22.19 for babies without immediate referral). Close family history of hearing loss was the next highest (10.93 for all babies, 12.29 for babies without immediate referral). The evidence for a targeted surveillance programme, based on risk factors, for babies in England who pass the newborn screen is not strong. [ABSTRACT FROM AUTHOR]

Automated pure-tone audiometry is frequently used in teleaudiology and hearing screening. Given the high prevalence of age-related hearing loss, older adults are an important target population. This study aimed to investigate the accuracy of automated audiometry in older adults, and to examine the influence of test frequency, age, sex, hearing and cognitive status. In a population-based study, two age-homogeneous samples of 70-year-olds (n = 238) and 85-year-olds (n = 114) were tested with automated audiometry in an office using circum-aural headphones and, around 4 weeks later, with manual audiometry conducted to clinical standards. The differences were analysed for individual frequencies (range: 0.25–8 kHz) and pure-tone averages. The mean difference varied across test frequencies and age groups, the overall figure being −0.7 dB (SD = 8.8, p < 0.001), and 68% to 94% of automated thresholds corresponded within ±10 dB of manual thresholds. The poorest accuracy was found at 8 kHz. Age, sex, hearing and cognitive status were not associated with the accuracy (ordinal regression analysis). Automated audiometry seems to produce accurate assessments of hearing sensitivity in the majority of older adults, but with larger error margins than in younger populations, and is not affected by relevant patient factors associated with old age. [ABSTRACT FROM AUTHOR]

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

Objective: This study's objective was to estimate hearing loss prevalence for noise-exposed US Utilities workers. Methods: In this cross-sectional study of a retrospective cohort, audiograms were examined for 1.3 million workers (13,595 within utilities) from 2010-2019. Hearing loss prevalence and adjusted risk as compared with a reference industry were estimated. Results: The hearing loss prevalence for noise-exposed Utilities workers (25%) was higher than for noise-exposed workers in all industries combined (20%). Some subsectors surpassed the prevalence for all industries combined and/or had adjusted risks significantly higher than the reference industry. The highest prevalence subsectors were Hydroelectric Power Generation (37%) and steam and Air-Conditioning Supply (29%). Conclusions: While often overlooked, noise-exposed workers in this sector have among the highest prevalences of hearing loss and significantly higher risks. Increased attention and better hearing conservation strategies are needed. [ABSTRACT FROM AUTHOR]

Programmable variable pressure valves were introduced in the 1980s, providing a non-invasive solution to post-operative alterations of the valve opening pressure to address problems of under or overdrainage. Since their increased use in the treatment of hydrocephalus, there have been case reports of unintentional alterations of the valve opening pressure following exposure to magnetic fields in everyday environments, from televisions to rollercoasters. Here we describe two cases of patients' programmable valves being altered following audiology assessments. We subsequently discuss some of the available research on the safety of these valves in various magnetic field strengths, alongside interim and updated recommendations made by the British Society of Audiologists with regards to testing of children with programmable shunts in place. [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]

Background: Rigid telescopes, which provide wider surgical feld imaging, improved resolution, and high magnifcation capabilities, have recently found widespread use in ear surgery. This study aimed to review the outcomes and duration of operations in endoscopic transcanal tympanoplasty and to guide surgeons who have just started endoscopic ear surgery (EES). Methods: This study included 47 outpatient or inpatient volunteers who underwent endoscopic transcanal tympanoplasty surgery at the Otolaryngology clinic between March 2021 and March 2023. The age and sex of the patients, the surgery duration, and the side of the operated ear were reviewed. The first 23 operated patients were compared with the last 24 operated patients in terms of the duration of the operation. Postoperative graft success (anatomical success) in the patients at 6 months was reviewed. Hearing gain in patients was examined postoperatively at 6 months using an audiometry test with hearing thresholds at 0.5, 1, 2, and 4 kHz. Results: Upon examination of the patients at 6 months, the graft success was 89.4%. There was a statistically signifcant recovery in all 4 frequencies based on the preoperative and postoperative hearing tests (P=.00). There was a signifcant decrease in the duration of the operation in patients who were operated in the later stages of the study (P=.00). Conclusion: Although there is a learning curve associated with EES, this type of operation is based on team effort, and the surgery duration decreases over time, with the experience acquired by each healthcare provider included in the team. [ABSTRACT FROM AUTHOR]

This study investigates audiovestibular dysfunction in individuals with long-standing diabetes mellitus (DM). A cross-sectional study was conducted involving 100 patients (DM for ≥ 10 years) at the Department of E.N.T. in Prakash Institute of Medical Sciences and Research, Sangli, Maharashtra. A mean age of 43.09 years among patients, with 64% male and 36% female participants. Hearing loss was the most common complaint, affecting 46% of subjects, followed by vertigo in 23%. Pure tone audiometry revealed that 34% of patients had sensorineural hearing loss, with varying degrees of severity. Vestibular dysfunction was observed in 10% of cases. Correlation analysis indicated a significant positive relationship between the duration of DM and hearing thresholds at various frequencies, as well as with HbA1c levels. This suggests a worsening of hearing with longer DM duration and higher HbA1c levels. The prevalence of hearing impairment was higher at higher frequencies, with vestibular dysfunction also noted in a subset of patients. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the comparative effectiveness of Click Auditory Brainstem Response (Click ABR) and Multiple Auditory Steady-State Response (Multi-ASSR) in identifying hearing impairments in infants. Recognizing auditory issues early is crucial for a child's cognitive and language development, as emphasized by the Joint Committee on Infant Hearing (JCIH) and the American Academy of Audiology (AAA). While Click ABR is widely utilized, Multi-ASSR offers a modern technique for detailed hearing assessment. Methods: A comparative analysis was conducted on 111 infants aged 1–6 months, previously screened for hearing at a tertiary care centre. The study employed both Click ABR and Multi-ASSR to evaluate their respective efficacy in assessing infant hearing. Results: Click ABR detected normal hearing in 87.4% of the infants, slightly higher than Multi-ASSR's 84.7%. A noteworthy finding was the higher incidence of bilateral versus unilateral hearing loss, with Click ABR identifying bilateral loss in 10 infants and unilateral loss in 4, compared to Multi-ASSR, which found bilateral loss in 12 infants and unilateral loss in 5. There was a minor but significant difference in auditory thresholds between the methods, with a mean discrepancy of 1.2 dB and a significant statistical variance (t-value of 15; p < 0.001), indicating variations in sensitivity. Conclusion: Both Click ABR and Multi-ASSR are indispensable tools in paediatric audiology, each with unique advantages. Click ABR excels in efficiency, suitable for rapid assessments and early detection. In contrast, Multi-ASSR offers comprehensive frequency-specific data, facilitating thorough evaluations. Healthcare professionals must grasp these methods' strengths to optimize infant hearing screenings and enhance early intervention strategies, aligning with JCIH and AAA guidelines. [ABSTRACT FROM AUTHOR]

Hearing loss is an important health care concern. Pure Tone Audiometry (PTA) is considered Gold Standard for audiometric evaluations though, there exist a huge variance between the demand and the actual services available. As smartphones are mobile, applications are upgradable, results are reproducible, the mobile applications may offer a good screening tool, especially in remote areas. There are many smartphone-based hearing applications which are already in use. However, effectiveness of such applications needs to be validated. To evaluate the reliability of 'Hearing Test' a phone application against PTA for assessment of hearing thresholds in adults. We conducted a diagnostic study on a heterogenous group of 250 individuals irrespective of their hearing levels. The hearing thresholds for both ears were measured by PTA and phone app and then compared statistically. The agreement between the methods were statistically significant with respect to diagnosing hearing loss and the degree of hearing loss. Though, PTA remains Gold Standard for hearing evaluation but freely available, highly reproducible & specific 'Hearing Test' application could be used as a screening tool in remote areas and may help bridging the gap between the requirement and availability of diagnostic audiometric services. [ABSTRACT FROM AUTHOR]

Background: The digit in the noise test is a simple hearing screening tool that can identify hearing loss at the early stage. This screening tool takes less time than traditional pure-tone audiometry. There is a scarcity of hearing health professionals with few resources for carrying out hearing screening on a large scale in India. Hence, a hearing screening tool for the Hindi-speaking population is needed. Aim and Objective: The study aimed to develop and validate the Digit in Noise test in Hindi (DIN-H). Methods: A native Hindi female speaker recorded single digits from 1 to 9 made into triplet combinations, which were binaurally presented to 20 normal hearing subjects having hearing thresholds less than 25 dBHL from 250 to 8000 Hz in the presence of broadband speech-shaped noise. The digit triplets were homogenized using speech intelligibility function for similar difficulty levels across stimuli. The homogenized stimuli were evaluated by obtaining the Speech Recognition Threshold (SRT) of 20 normal hearing subjects. Results: The Mean SRT was − 10.4 and − 11.3 dB before and after homogenization. A strong positive correlation existed between test and retest SRTs (0.78). Mean SRT and slope obtained before and after optimization were comparable to other languages like Korean and English. This test can act as a reliable screening tool for assessing individuals. The test was administered to 106 normal hearing participants. The 95th percentile of the SRT value obtained was − 5.6 dB, which was kept as a cut-off score for the screening test. Conclusion: DIN-H can be used as a screening tool for assessing the integrity of the auditory system on a large scale in less time for the Hindi-speaking population. [ABSTRACT FROM AUTHOR]

Objective: Exploring the auditory and vestibular manifestations associated with chronic kidney disease (CKD) has been growing in recent years. Understanding these complaints in CKD patients is crucial for comprehensive patient care. This review aimed to investigate the audiological findings and profiles across various stages of CKD and guide for informed decision-making in their management. Methods: Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified for review. The selected articles were published from 2008 to 2023 and written in English language. A total of 41 articles on auditory and vestibular assessments in CKD were eligible for review. Results: Pure tone audiometry (PTA), immittance audiometry (IA) and otoacoustic emissions (OAEs) were the most commonly employed hearing tests respectively, with a higher frequency of utilization in hemodialysis cases compared to non-hemodialysis ones. Also, vestibular evoked myogenic potentials (VEMPs) emerged as the most popular vestibular test among hemodialysis patients while questionnaires were frequently employed in CKD patients. Moreover, our analysis suggests a potential association between the duration of hemodialysis and the development of tinnitus and vertigo. Abnormalities were also observed in auditory brainstem response (ABR), speech audiometry, central auditory processing tests and videonystagmography (VNG) assessment in hemodialysis and non-hemodialysis patients. Conclusion: CKD patients, particularly those undergoing hemodialysis, face a higher risk of hearing loss, tinnitus, and vestibular complaints. Performing otoacoustic emissions and vestibular-evoked myogenic potentials along with PTA on CKD patients, regardless of the disease stage is recommended to more effective management of audiovestibular complaints in these population. [ABSTRACT FROM AUTHOR]

Purpose: Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults. Method: We analyzed data collected from 128 adults (20-79 years of age, Mage = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears. Results: Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population. Conclusions: Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted. [ABSTRACT FROM AUTHOR]

Background: The ototoxicity of both chemotherapy and radiotherapy has been studied. Little is known regarding their impact on the vestibular system, particularly, the laboratory vestibular testing that evaluates the effects of both chemotherapy and radiotherapy on the peripheral and central vestibular system. Consequently, the current research was designed to study Videonystagmography (VNG) and video head impulse test (vHIT)in patients with head and neck cancer receiving chemotherapy and radiotherapy for early diagnosis of vestibularsystem abnormalities. Methods: This study included two groups with head and neck cancer: group I included 19 patients receiving chemotherapy and group II included 19 patients receiving radiotherapy. Basic audiological evaluation, VNG, and vHIT were conducted on all patients before treatment and 3 months following treatment. Results: Regarding pure tone audiometry, there was a statistically significant increase in hearing threshold at high frequencies in patients receiving chemotherapy and radiotherapy before and after treatment. As regards the VNG test, there was a statistically significant impairment in saccade, smooth pursuit, optokinetic, and caloric tests in patients before and after receiving chemotherapy. However, in patients receiving radiotherapy, there was no statistically significant difference in the VNG test battery except for increased value of caloric weakness. vHIT abnormalities were reported in patients of both groups. Conclusions: This study demonstrated the ototoxic and vestibulotoxic effects of both chemotherapy and radiotherapy in patients with head and neck cancer. [ABSTRACT FROM AUTHOR]

Background: This study examined the relationship between behavioural thresholds as measured by pure tone audiometry and electrophysiological thresholds measured by the Auditory Steady-State Response (ASSR) in children with normal hearing and sensorineural hearing loss. Materials and Methods: After being assessed, 45 children of both sexes, ranging in age from 5 to 15, were split into four groups: 10 with moderate to moderately severe sensorineural hearing loss (G2M); 10 with steeply sloping sensorineural hearing loss (G2D); 10 with profound and severe sensorineural hearing loss (G2S); and 15 with normal hearing (G1). ASSR, tympanometry, acoustic reflex testing, pure tone audiometry, and speech audiometry (SRT and SDT) were performed. Results: The electrophysiological maximum in the group with normal hearing thresholds varied from 19 to 27 dB NA. The correlation in the group with moderate to moderately severe hearing loss was 0.42–0.74. The correlation in the steeply sloping hearing loss group was 0.68–0.94. The correlation in the group of people with profound and severe hearing loss was 0.59–0.86. The normal hearing group's mean differences in ASSR threshold and audiometric threshold ranged from −0.3 to 12 dB, in the moderate and moderately severe hearing loss group from −9 to 2 dB, in the steeply sloping hearing loss group from 1.4 to 7.5 dB, and in the severe and profound hearing loss group from −0.40 to 8.5 dB. Conclusion: As expected, there was no strong relationship between behavioural and electrophysiological thresholds in the group with normal hearing. But in children with hearing loss, there was a strong correlation between electrophysiological and behavioural thresholds; this relationship was especially evident in children with severe and profound hearing loss and those with steeply sloping hearing loss. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare daily and total recreational music exposure levels and extended-spectrum audiogram results in young adults without pre-existing hearing problems. Design: The study included healthy volunteers aged 18–25 with no known ear disease or hearing loss. Participants completed a questionnaire, underwent otoscopic and tympanometric examinations, and determined preferred music volumes in an audiometry booth using calibrated music samples of their preferred genres. Hearing thresholds up to 16 kiloHertz (kHz) were measured. Daily music exposure for each participant was normalized to 8 h to calculate a time-weighted average of 8 h (TWA8). Total exposure (TE) was calculated by multiplying TWA8 by the number of years of music listening. Results: A total of 32.4% of participants had TWA8s above 65 dB. Their hearing thresholds at 125, 250, 500, and 16,000 Hz and the average of 125 Hz–8 kHz were significantly higher. Participants with TWA8s above 65 dB were also more prone to speaking loudly and experiencing communication difficulties on the phone. Those with a TE of more than 400 experienced significantly more speech discrimination difficulty in noisy environments and temporary hearing loss/tinnitus after exposure to loud music. Participants with a TE above 700 had worse thresholds at 4, 14, and 16 kHz frequencies, as well as 125–8000 Hz and 500–4000 Hz averages compared to those with a TE below 700. Conclusions: This study provides evidence that recreational music with much lower exposure levels than the universally accepted TWA8 of 85 dB could negatively impact hearing in healthy young adults. Therefore, maintaining a maximum TWA8 of 65 dB is recommended. [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]

Purpose: To describe the clinical, audiological, and psychometric features observed in patients with chronic tinnitus and rare variants in the ANK2 gene. Methods: We report a case series of 12 patients with chronic tinnitus and heterozygous variants in the ANK2 gene. Tinnitus phenotyping included audiological (standard and high-frequency audiometry, Auditory Brainstem Responses (ABR) and Auditory Middle Latency Responses (AMLR)), psychoacoustic and psychometric assessment by a Visual Analog Scale (VAS) for tinnitus annoyance, the Tinnitus Handicap Inventory (THI), the test on Hypersensitivity to Sound (THS-GÜF), the Patient Health Questionnaire (PHQ-9), the Hospital Anxiety and Depression Scale (HADS) and the Montreal Cognitive Assessment (MoCA). Results: All patients reported a persistent, unilateral noise-type tinnitus, mainly described as white noise or narrowband noise. Seven patients (58%) were considered to have extreme phenotype (THI score > 76), and all patients reported some degree of hyperacusis (THS-GÜF score > 18 in 75% of patients). Seven patients scored MoCA < 26, regardless of the age reported, suggesting a mild cognitive disorder. ABR showed no significant differences in latencies and amplitudes between ears with or without tinnitus. Similarly, the latencies of Pa, Pb waves, and NaPa complex in the AMLR did not differ based on the presence of tinnitus. However, there were statistical differences in the amplitudes of Pa waves in AMLR, with significantly greater amplitudes observed in ears with tinnitus. Conclusion: Patients with ANK2 variants and severe tinnitus exhibit an endophenotype featuring hyperacusis, persistent noise-like tinnitus, high-frequency hearing loss, and decreased amplitudes in AMLR. However, anxiety, depression, and cognitive symptoms vary among individuals. [ABSTRACT FROM AUTHOR]

The hearing aid adoption rate among older adults in Japan is lower than that in other developed countries. Herein, a survey was conducted to identify this bottleneck and develop countermeasures. This study aimed to examine whether raising awareness of the relationship between hearing loss and dementia is significant for hearing tests and adopting hearing aids. A questionnaire was administered to participants aged 65 or older who visited a general hospital to determine the background factors (1) for a recent history of hearing tests, (2) for the desire to visit an otolaryngologist and have a hearing test, (3) for recognizing the hearing loss–dementia relationship, and (4) for adopting hearing aids. A total of 517 patients (mean age, 78.06; SD 6.97), representing 2.4% of the region's older-adult population, participated in the survey. A history of hearing tests within five years was significantly associated with recognizing the hearing loss–dementia relationship (adjusted OR 2.36, 95% CI 1.49–3.72). The desire to visit an otolaryngologist or have a hearing test was significantly associated with recognizing the hearing loss–dementia relationship (adjusted OR 1.70, 95% CI 1.02–2.85). Moreover, 39.3% were aware of the hearing loss–dementia relationship. The significant associated factors were being female (OR 2.50, 95% CI 1.64–3.81) and having interpersonal hobbies (OR 1.66, 95% CI 1.11–2.49). The significant background factors for adopting hearing aids were older age (OR 6.95, 95% CI 1.90–25.40), self-reported severe hearing impairment (OR 5.49, 95% CI 2.55–11.80), and living alone (OR 2.63, 95% CI 1.18–5.89). Recognizing the hearing loss–dementia relationship was not a significant factor. Raising awareness of the hearing loss–dementia relationship was not associated with adopting hearing aids for self-reported hearing impairments. However, it may be associated with otolaryngology visits and hearing tests. Thus, steps like hearing screening for older adults are also essential. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated student performance and perception of a simulated hearing screening utilizing an adult standardized patient (SP). It explored the relationship between student performance and student perception of the simulation. Method: Sixty-nine first-year speech pathology graduate students completed a high-fidelity simulation to demonstrate competency in hearing screening administration with an adult SP. Student performance was assessed by supervising educators through standardized rubrics in the following domains: (a) explaining the task, (b) following the university screening protocol, (c) demonstrating clinical and critical thinking, and (d) using the audiometer efficiently. Students also completed surveys to provide feedback regarding their simulation experience. Results: The median rating for student performance across the four domains evaluated was determined using nonparametric tests, while a one-sample t test was used to determine average ratings. Additionally, central tendency and dispersion measures were computed using rubric ratings of students' performance in each domain evaluated. Overall, students performed well in this simulation, with nearly all students demonstrating competency in explaining the task and demonstrating clinical/critical thinking. Following the screening protocol and using the audiometer efficiently showed the most room for improvement. Student survey responses generally indicated that this was a positive and beneficial learning experience and provided constructive feedback for future iterations of this simulation. Conclusions: Hearing screening simulations effectively train graduate speech-language pathology students in the necessary skills. Student perceptions of this simulation were resoundingly positive. [ABSTRACT FROM AUTHOR]

Background: Cisplatin-based chemoradiation is a standard treatment for many patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC), an etiologically distinct subset of head and neck cancer. Although associated with good long-term survival, clinical risk factors for ototoxicity have been understudied in this population. This study aimed to evaluate clinical predictors associated with ototoxicity in HPV-positive OPSCC patients treated with cisplatin chemoradiation. Methods: This retrospective case-control study included 201 adult patients (>18 years) with histologically confirmed HPV-positive OPSCC who received cisplatin chemoradiation as their primary treatment from 2001 and 2019 at a single tertiary cancer center. Ototoxicity was determined using baseline and follow-up audiometry and the Common Terminology Criteria for Adverse Events v5.0 grading criteria (Grade ≥2). Multivariable logistic regression [adjusted odds ratio (aOR)] identified significant predictors that increased the odds of ototoxicity. Results: A total of 201 patients [165 males; median (IQR) age, 57 (11) years] were included in the study. The incidence of ototoxicity in the worst ear was 56.2%, with the greatest hearing loss occurring at high frequencies (4-8 kHz), resulting in a loss of 12.5 dB at 4 to 6 kHz and 20 dB at 6 to 8 kHz. High-dose cisplatin administration compared to weekly administration [aOR 4.93 (95% CI: 1.84-14.99), P =.003], a higher mean cochlear radiation dose [aOR 1.58 (95% CI: 1.12-2.30), P =.01], smoking history [aOR 2.89 (95% CI: 1.51-5.63), P =.001], and a 10 year increase in age [aOR 2.07 (95% CI: 1.25-3.52), P =.006] were each independently associated with increased odds of ototoxicity. Conclusions: Clinical predictors of ototoxicity in HPV-positive OPSCC patients treated with cisplatin-based chemoradiation include the use of a high-dose cisplatin regimen, higher cochlear radiation doses, a history of smoking, and older age. With the rising incidence of this malignancy in Western countries and overall improved survivorship, our research motivates future studies into risk stratification and earlier interventions to mitigate and reduce the risk of ototoxicity. [ABSTRACT FROM AUTHOR]