International Journal of Audiology最新文献

Objective: This systematic review addressed two questions: 1) For which audiometric test frequencies or pure tone averages are hearing threshold levels (HTLs) most susceptible to early occupational noise induced hearing loss (NIHL) before significant damage? 2) Which early flag metric best detects early hearing shifts due to noise for occupational NIHL surveillance?

Design: Systematic searches were conducted in Ovid MEDLINE(R) and Embase from July 2021 to May 2024. Eligibility was screened by two independent reviewers using Covidence. HTL results were analysed for susceptibility to noise-induced changes, and sensitivity and specificity of early flag metrics were assessed.

Study sample: Of 175 studies retrieved, 18 met the inclusion criteria.

Results: Ten studies emphasised the importance of testing at frequencies above 8 kHz, with HTLs at 12, 14, and 16 kHz frequently identified as the most noise susceptible. Conventional frequencies of 3-6 kHz were also noted as susceptible. NIOSH and OSHA metrics had low sensitivity and specificity, but modifications improved their performance to 100% sensitivity and 98% specificity.

Conclusion: The review highlights the need to refine current metrics and explore extended high frequencies for NIHL monitoring. Research is required to determine frequencies for warning metrics and sensitive metrics for early occupational NIHL detection.

Objective: Employing automated language analysis, specifically Meaning Extraction Method (MEM) and Principal Component Analysis (PCA), to identify key factors in open-text responses about hearing aid experiences.

Design: Exploratory, cross-sectional design, using an online questionnaire. Responses to a single open-ended question were analysed using MEM, PCA, regression, and correlation analyses.

Study sample: Participants (n = 538) included adult hearing aid users sampled from the Hearing Tracker website community and Lexie Hearing user databases in the United States.

Results: The MEM-derived items revealed six factors related to hearing aid experiences: (1) life change, (2) social situation, (3) quality of life, (4) impact and speech understanding, (5) communication and interaction, and (6) music and environmental sounds. IOI-HA item 3 had the most statistically significant correlations with PCA factors. Quantile regression revealed that factors one and two significantly predicted the IOI-HA total score. Positive correlations were observed between self-reported hearing difficulty and factors one, four, and five, as well as between factor one and general health and factor two and physical activity.

Conclusion: Natural language analysis of open-ended textual responses can offer valuable insights into hearing aid users' experiences. Future studies should aim to refine this methodology to enhance clinical relevance and generalisability.

Objective: The present study aimed to objectively assess the charge integration efficiency (CIE) of the auditory nerve using electrically-evoked stapedial reflex threshold (eSRT) measurements in paediatric cochlear implant users.

Design: The eSRT was estimated in two ways: by keeping pulse width constant while increasing pulse amplitude and vice versa. The electrical dynamic range (EDR) obtained for eSRT was measured with increasing pulse amplitude (EDR_PA) and pulse width (EDR_PW) by calculating the difference in charge units between eSRT and behavioural thresholds; further, CIE was estimated.

Study sample: Fifteen paediatric cochlear implant users.

Results: EDR_PW was 1.4 to 1.7 times larger than EDR_PA. The EDR_PW was significantly greater than the EDR_PA. A significant correlation was observed between both EDR measures. However, the CIE measure did not significantly correlate with the behavioural threshold. Further, there was no significant effect of electrode location on the CIE.

Conclusions: The CIE estimated with objective measures such as eSRT is comparable to those estimated using behavioural loudness judgments. eSRT can serve as a quick method to estimate the CIE, which can be easily implemented in the paediatric population. The CIE could be a valuable tool for differentiating electrodes with excellent and poor charge integration efficiency.

Objective: This study aimed to evaluate long-term cochlear implant (CI) outcomes in individuals with mono-allelic pathogenic variants in WFS1, which is associated with both Wolfram-like syndrome and DFNA6/14/38.

Design: Retrospective case series.

Study sample: Seven CI recipients, ranging from eight months to 58 years of age, were included in the study, including four with Wolfram-like syndrome and three with DFNA6/14/38. A total of ten cochlear implantations were performed among these subjects.

Results: At one-year post-implantation, a mean phoneme score of 90 ± 9% at 65 dB SPL in quiet was found, which remained stable up to ten years post-implantation with a mean phoneme score of 94 ± 6%. Despite these excellent outcomes, one subject achieved no speech recognition with CI and eventually became a non-user. This individual had a prolonged absence of auditory stimulation prior to implantation and encountered multiple challenges during rehabilitation.

Conclusion: Individuals with Wolfram-like syndrome or DFNA6/14/38 demonstrate consistently good outcomes following implantation, which remain stable over time. These findings affirm cochlear implantation as an effective rehabilitation option for these individuals. Furthermore, the stable and good CI outcomes contradict the suggested link between WFS1-associated sensorineural hearing loss and auditory neuropathy.

Objective: To examine the clinical and genetic characteristics of childhood-onset bilateral sensorineural hearing loss (SNHL) in Finland.

Design: Retrospective analysis.

Study sample: A total of 249 children younger than 18 years were diagnosed with bilateral SNHL in Oulu University Hospital, Finland, from 2017 to 2022.

Results: Pathogenic or likely pathogenic gene variants or chromosome abnormalities explaining SNHL were identified in 41% (N = 101/249) of children. Likely causative variants were more commonly identified in patients with severe SNHL than in those with moderate or mild SNHL. Our study identified likely causative gene variants in 24 different genes and six different likely causative chromosome abnormalities, demonstrating the genetic heterogeneity of SNHL. Population-enriched founder mutations were identified in the CABP2, CLRN1, MYO7A, SUCLA2, TMC1, and TWNK genes. A significant number of patients had associated phenotypes, including global developmental delay or intellectual disability (16%), language disorder (20%), ophthalmological abnormalities (16%), or malformations other than those involving the ear (10%).

Conclusions: SNHL is genetically and clinically heterogeneous. Pathogenic variants in GJB2 were the most common. Several population-enriched variants were identified as causing SNHL in the northern Finnish population. Associated medical phenotypes are common and should be taken into account in patients' follow-up and treatment.

Objective: To investigate the perspectives and experiences of adults with hearing loss (HL), their family members, and hearing care professionals on how they respond to the stigma of HL and hearing aids (HAs).

Design: Qualitative descriptive approach using semi-structured interviews.

Study sample: Three participant groups were recruited, including 20 adults over the age of 50 years with HL, 20 family members who had a close relationship to the adults with HL, and 25 hearing care professionals.

Results: Three themes described how adults with HL, family members, and hearing care professionals respond to the stigma of HL and HAs, namely: (1) some people tell others about their HL and HAs and some people don't; (2) telling or not telling depends on the situation; and (3) people deal with the stigma of HL and HAs in different ways.

Conclusions: This study revealed a range of volitional responses to the stigma of HL and HAs. People affected by HL may not tell others about their HL and/or HAs because of the stigma, and these volitional responses are influenced by situational cues. Adults with HL and family members manage the stigma of HL and HAs in different ways and require a person-centred approach.

Objective: We assessed the interaction between self-efficacy and joint problems and self-efficacy and visual problems on the risk of hearing aid abandonment in older adults.

Design: A retrospective cohort study comprising older adults who received hearing aids in Chile was conducted. Hearing aid self-efficacy was measured using the S-MARS-HA questionnaire, while joint and visual problems were assessed through self-reported questions. Survival regression models were conducted to investigate the interaction between self-efficacy and joint problems, as well as self-efficacy and visual problems.

Study sample: The study included 355 older adults who received hearing aids through the Chilean public health sector.

Results: A significant interaction effect indicated that the relationship between self-efficacy and the risk abandonment was influenced by joint problems (p < 0.05). In the subpopulation with joint problems, self-efficacy was associated with a reduced risk of hearing aid abandonment (HR = 0.81), whereas in the subpopulation without joint problems, the protective effect was more pronounced (HR = 0.52). The interaction between self-efficacy and visual problems was not significant.

Conclusions: The interaction between self-efficacy and joint problems was associated with the risk of abandonment. Addressing limitations associated with joint problems and individuals' confidence in using their hearing aids could reduce the abandonment.

Objective: To assess acceptability and benefit of a community-based hearing intervention delivered at no cost to lower-income older adults with untreated hearing loss in New Brunswick, Canada.

Design: Mixed method pre-post intervention study investigating aspects of communication function and social support at baseline and three months post-intervention.

Study sample: 124 of 175 independent-living older adults screened at the study site and in local community centres in low-income neighbourhoods were recruited into the study.

Results: In 70 (56.5%) participants self-identified as female and 54 (43.5%) as male, with mean age of 74.5 years, mean effect sizes measured from baseline to 3-months post-intervention were 0.99 (large) for HHIE-S, 0.58 (medium) for DSSI, and 1.02 (large) for LSEQ indicating significant improvement in self-perceived communication function, social support and listening self-efficacy, respectively.

Conclusion: The HEARS program is feasible to implement, despite Covid-19 pandemic related challenges, highly acceptable to participants, and associated with a range of benefits that include improved communication function, self-efficacy and social support. The success of HEARS in a new population in a second Canadian province indicates its adaptability and suitability for scaling to extend the reach of hearing services for older adults who may not otherwise access care.

Objective: Our primary purpose was evaluation of early benefits of lifestyle modification on symptoms of vestibular migraine. The secondary purpose was to determine if a patient's global sense of coping relates to outcomes with lifestyle modification.

Design: Prospective observational cohort. Participants completed questionnaires related to dizziness handicap, headache disability, and adherence to lifestyle modifications at baseline and weekly over 30 d. Sense of coping was measured pre-intervention.

Study sample: Thirty-eight patients with vestibular migraine diagnosed in tertiary care setting between 2022 and 2023.

Results: Symptoms were better at all four weeks post-intervention than pre-intervention (p < 0.01), with no difference across weeks two through four (p > 0.10) when symptoms were lowest and stable. By week two, 52% and 18.5% of participants had significant improvement in dizziness and headache compared to published critical difference scores, respectively. Sense of coping was inversely correlated with dizziness (R = -0.53, p < 0.00001) and headache (R = -0.64, p < 0.0001).

Conclusions: Lifestyle modification reduced dizziness and headache in many vestibular migraineurs in the first two weeks following intervention. Improvement in restful sleep was associated with improvement in symptoms. Sense of coping did not predict improvement but was inversely related to symptoms. Lifestyle modification could be considered as sole management or in addition to pharmacological intervention.

Objectives: To assess the effect of forward and omnidirectional microphone configurations in BiCROS versus monaural hearing aids on objective and subjective outcomes in different noise conditions.

Design: After fitting and a 4-week acclimatisation period, speech recognition and sound quality were measured using forward directional, omnidirectional, and unaided settings. Two noise configurations were used, surrounding noise and noise presented from the aided (better) ear. Subjective outcomes were assessed using the SSQ-b and BBSS questionnaires and participant interviews.

Study sample: Eighteen adult participants (mean: 74.6 y; range: 61-94 y; ten males, eight females) with mild to moderately severe SNHL in their better ear (PTA0.5-4khz > 20 dB HL) and limited usable hearing in their poorer ear (average PTA0.5-4khz > 100 dB HL).

Results: Significant improvement in speech recognition and sound quality for BiCROS and monaural directional settings over omnidirectional and unaided, in both noise configurations. There were no significant differences observed between monoaural and BiCROS directional settings.

Conclusion: Speech in noise recognition and sound quality scores demonstrated a significant directional benefit for both BiCROS and monaural directional fitting settings over omnidirectional and unaided conditions. Unique BiCROS-specific experiences were identified in a patient-oriented approach. These can inform the development of BiCROS-tailored tools.