International Journal of Audiology最新文献

Objective: To use a standardised reporting tool to identify potential eligible candidates for cochlear implant (CI) referral and quantify the proportion of adults who had a CI referral discussion after presenting with an audiogram within United Kingdom (UK) audiometric criteria.

Design: Retrospective multicentre 6-month audit of Audiology clinic databases.

Study sample: A total of 810 adults from five geographically diverse UK Audiology sites.

Results: Data were collected in late 2019 after UK CI audiometric candidacy criteria changed; one site collected only 3 months of data. The proportion of potential eligible adults (based only on audiometry) considered for CI referral was 64% (521 out of 810) and varied by site (from 50% to 83%). About 24% of patients (123 out of 521) declined CI referral; this also varied across sites (12-45%). The median age of patients where CI referral was not considered was 80 years - significantly higher than the group where CI referral was considered (73 years).

Conclusions: CI referral is dependent on where adults live, and how old they are. Older adults are significantly less likely to be considered for CI referral by Audiologists. Audiology clinics need more support to empower staff to talk to patients about CI referral.

Objectives: The purpose of this study was to describe changes in audiometric thresholds over time in children whose hearing loss demonstrated early mild progression.

Design: This was a retrospective follow-up study to examine long-term audiologic results in children with progressive loss.

Study sample: We examined audiologic data for 69 children, (diagnosed from 2003 to 2013), who had been previously categorised as having "minimal" progressive hearing loss.

Results: Children had a median of 10.0 (7.5, 12.1) years of follow-up and a median age of 12.5 (IQR: 11.0, 14.5) years; 92.8%; 64 of 69) of children continued to show progressive hearing loss (defined as a decrease of ≥10 dB at two or more adjacent frequencies between 0.5 and 4 kHz or a decrease in 15 dB at one frequency) in at least one ear since diagnosis. Further examination showed that 82.8% of ears (106 of 128) had deterioration in hearing. Of the 64 children, 29.7% (19/64) showed further deterioration since the first analysis.

Conclusion: More than 90% of children identified as having minimal progressive hearing loss continued to show deterioration in hearing. Ongoing audiological monitoring of children with hearing loss is indicated to ensure timely intervention and to better counsel families.

Objective: The aim of this project was to investigate the provision of counselling in adult audiological rehabilitation and to highlight training barriers and needs.

Design: A service evaluation in which respondents completed a survey in which they rated their knowledge, confidence and competence in addressing the hearing, social and emotional needs of their patients. They were also asked to define counselling.

Sample: 64 UK practising audiologists in adult audiological rehabilitation, aged 20->60 years (84% females, 16% males), with a range of years in clinical practice.

Results: Counselling definitions fell into three main categories: the audiologist as the doer, the audiologist as the facilitator, and the audiologist and patient as partners. Respondents reported feeling more able to counsel the hearing related needs of their patients, than emotional or social needs. There were significant positive statistical associations between counselling training completed and self-rated counselling abilities for managing emotional needs. Clinical experience was not associated with self-rated counselling. Lack of supervision and training were identified as some of the main barriers to providing emotional support. Almost all respondents reported a desire for further training in delivering emotional support, with the belief that this would improve services and patient outcomes.

Conclusions: UK audiologists demonstrated person-centred thinking through their definitions of counselling. However, they reported significant barriers in being able to support the needs of adults with hearing loss. Training needs around emotional support in audiology counselling are not currently being met. It is important for clinical training programmes to address this gap by incorporating more counselling courses into their curricula.

Objective: Best-practice guidelines recommend the use of hearing aid verification in children; however, this is not always performed. Automated hearing aid verification has been reported to be more accurate and efficient than manual verification in adults, but it is not known if this transfers to the paediatric population.

Design: A within-group design compared manual and automated hearing aid verification on four measures; fitting accuracy, prescription targets, completion time, and the speech intelligibility index.

Sample: Twenty paediatric patient hearing aid profiles (M = 8.25 years) with unilateral or bilateral hearing aids.

Results: A Wilcoxon-signed rank test indicated manual verification achieved a significantly closer match to target at 0.5 kHz, by an average of 1 dB. There were no significant differences at any other frequency. Across 80 comparisons (four frequencies measured in 20 listeners), 82.5% of automated verifications were identical to, or within 1 dB of, manual verifications. A paired-samples t-test confirmed automated verification to be an average of 91.9 seconds faster than manual verification.

Conclusion: Automated verification was able to provide an accurate match to target within recommended tolerances for hearing aid fittings and was significantly quicker than manual verification. These data suggest that automated verification of hearing aids could play a role in paediatric audiological management.

Objective: It is thought that decreased sound tolerance can be subdivided into distinct types including misophonia (involving specific trigger sounds) and hyperacusis (broader in profile). However, there are few established methods for differentially assessing these disorders and this is complicated by the fact that some measures (e.g. the HQ Hyperacusis Questionnaire) were developed before the concept of misophonia was accepted.

Design/study sample: We took a group of N = 119 participants with misophonia (varying in severity) and asked them about the presence of hyperacusis (based on a scoping review definition).

Results: Scores for some items on the HQ were correlated with scores for misophonia severity (e.g. social impact of sound) and others with scores for hyperacusis (e.g. ability to concentrate in noise). Similarly, some trigger sounds were more indicative of hyperacusis (e.g. dishes being stacked) and others were more indicative of misophonia in the absence of hyperacusis (e.g. chewing).

Conclusions: These double dissociations provide compelling evidence for separable forms of sound intolerance. Moreover, our research suggests that a single-item question about hyperacusis is associated with other characteristics of hyperacusis, even when assessed 18 months later.

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.