International Journal of Audiology最新文献

Objective: Illness perceptions refer to thoughts and ideas an individual has about an illness. The aim was to understand how cochlear implant (CI) users' illness perceptions, in addition to their monosyllabic word recognition abilities, are associated with their self-perceived sound quality.

Design: Data were collected during routine CI check-up appointments. Participants completed the Brief Illness Perception Questionnaire (assessing their illness perceptions) and the Hearing Implant Sound Quality Index (assessing their subjective sound quality). Additionally, monosyllabic word recognition abilities were measured with the Freiburg Monosyllable Word Test. Hierarchical regression analysis were utilised to model users' sound quality ratings. Participants' age was entered first as a control variable. In the next step, monosyllabic word recognition was entered. Finally, participants' illness perceptions were entered.

Study sample: Fifty-five participants with unilateral CI provision.

Results: Monosyllabic word recognition was significant in the second step. When illness perceptions and monosyllabic word recognition were both included in the third step, illness perceptions, but not monosyllabic word recognition, were significant. The model explained 22% of the variance of subjective sound quality.

Conclusions: Monosyllabic word recognition abilities and illness perceptions of CI users are important for their self-reported sound quality, but illness perceptions appear to be potentially more relevant.

Objectives: Standard diagnostic measures focus on threshold elevation but hearing concerns may occur independently of threshold elevation - referred to as "hidden hearing loss" (HHL). A deeper understanding of HHL requires measurements that locate dysfunction along the auditory pathway. This study aimed to describe the relationship and interdependence between certain behavioural and physiological measures of auditory function that are thought to be indicative of HHL.

Design: Data were collected on a battery of behavioural and physiological measures of hearing. Threshold-dependent variance was removed from each measure prior to generating a multiple regression model of the behavioural measures using the physiological measures.

Study sample: 224 adults in the United States with audiometric thresholds ≤65 dB HL.

Results: Thresholds accounted for between 21 and 60% of the variance in our behavioural measures and 5-51% in our physiological measures of hearing. There was no evidence that the behavioural measures of hearing could be predicted by the selected physiological measures.

Conclusions: Several proposed behavioural measures for HHL: thresholds-in-noise, frequency-modulation detection, and speech recognition in difficult listening conditions, are influenced by hearing sensitivity and are not predicted by outer hair cell or auditory nerve physiology. Therefore, these measures may not be able to assess threshold-independent hearing disorders.

Objectives: (1) to determine whether the standard Dutch word lists for speech audiometry are equally intelligible in normal-hearing listeners (Experiment 1), (2) to investigate whether synthetic speech can be used to create word lists (Experiment 1) and (3) to determine whether the list effect found in Experiment 1 can be reduced by combining two lists into pairs (Experiment 2).

Design: Participants performed speech tests in quiet with the original (natural) and synthetic word lists (Experiment 1.). In Experiment 2, new participants performed speech tests with list pairs from the original lists constructed from the results of Experiment 1.

Study samples: Twenty-four and twenty-eight normal-hearing adults.

Results: There was a significant list effect in the natural speech lists; not in the synthetic speech lists. Variability in intelligibility was significantly higher in the former, with list differences up to 20% at fixed presentation levels. The 95% confidence interval of a list with a score of approximately 70% is around 10%-points wider than of a list pair.

Conclusions: The original Dutch word lists show large variations in intelligibility. List effects can be reduced by combining two lists per condition. Synthetic speech is a promising alternative to natural speech in speech audiometry in quiet.

Objective: To explore the impact of remote versus in-person ear-nose-and-throat (ENT) specialist screening before hearing treatment on self-reported hearing aid (HA) benefit and satisfaction among adult first-time HA users.

Design: Participants were randomised to either remote or in-person ENT assessment before treatment initiation. Hearing ability, hearing quality, and treatment satisfaction were assessed pre- and post-HA treatment using the SSQ12, IOI-HA, and selected items from the 2021 Danish national Patient-Reported Experience Measures. Average daily HA usage was also recorded.

Study sample: 751 adult potential first-time HA users with self-reported hearing impairment were included; 501 participants were remotely assessed in private or public audiological clinics, and 250 control group participants were assessed in-person by private ENT specialists. Of the 658 participants who completed the entire trial, 454 received HAs.

Results: No significant post-treatment HA benefit differences were found between groups. Remotely assessed HA recipients in private clinics expressed slightly higher staff and waiting time satisfaction. Participants with normal hearing and mild/moderate hearing loss reported higher pre-treatment hearing ability and quality. No significant difference in average daily HA usage was observed between groups.

Conclusions: Findings suggest that remote screening does not compromise patient-reported HA benefit and satisfaction when compared to in-person screening.

Objective: Approximately 30-50% of sudden sensorineural hearing loss (SSNHL) patients show poor response to systemic steroid therapy. Additionally, the most appropriate treatment for patients with refractory sudden sensorineural hearing loss (RSSNHL) is unknown. This study aimed to explore the best treatment for RSSNHL.

Design: Using a frequentist contrast-based model and PRISMA guidelines, this study compared five salvage regimes: intratympanic injection of steroids (ITS), hyperbaric oxygen (HBO) therapy, post auricle steroid injection (PSI), ITS combined with HBO therapy, and continued systemic steroids.

Study sample: We searched the PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomised controlled trials and cohort studies comparing treatment regimens for RSSNHL.

Results: Compared with the control group (no additional treatment), PSI and ITS demonstrated significant improvements. The mean hearing gain was greater after PSI (11.1 dB [95% CI, 4.4-17.9]) than after ITS (7.7 dB [95% CI, 4.8-10.7]). When a restricted definition of RSSNHL was used, the ITS + HBO therapy showed the largest difference in improvement for pure tone average compared with the control group (14.5 dB [95% CI, 4.2-25.0]).

Conclusions: The administration of either PSI or ITS leads to the greatest therapeutic effect in patients with RSSNHL. However, a consensus on the definition of RSSNHL is needed.

Objective: to evaluate the levels of successful hearing preservation and preservation of functional hearing following cochlear implantation (HPCI) in children using the Cochlear Nucleus® Slim Straight Electrode (SSE).

Design: retrospective case note review of paediatric HPCI cases in our CI centre from 2013 to 2023. Inclusion criteria were attempted hearing preservation surgery, SSE used for implantation, pre-operative hearing thresholds ≤80dBHL at 250 Hz, CI before 18 years of age. Patients were excluded if no postoperative unaided PTA was obtained (poor attendance). Primairy outcome was hearing preservation using the HEARRING group formula; secondary outcome was residual functional hearing (≤80dBHL at 250 Hz/<90dB LFPTA).

Study sample: 56 patients with 94 CI's were included for review.

Results: Hearing preservation was achieved in 94.7% (89/94) of ears and complete preservation in 72% (68/94)). Average functional hearing was preserved in 89% using both criteria for preservation. Long-term follow up data was available for 36 ears (average 35.2 months), demonstrating 88.9% (32/36) complete preservation.

Conclusion: We have reliably achieved and maintained a high success rate of HPCI using the SSE in our paediatric population. The field of HPCI would benefit from unification of outcome reporting in order to optimise the evidence available to professionals, patients and their carers.

Objective: Hearing decline in ageing increases the risk of loneliness and social isolation. This correlation is most often observed when hearing is measured by subjective self-report, and less often for objectively measured speech listening ability, raising questions about differences between self-assessments and behavioural performance. This study compared self-reported hearing ability and objective speech-in-noise performance as predictors of loneliness and social isolation in adults older than 60.

Design: This was an observational, cross-sectional online study. Participants were instructed to complete a speech-in-noise task to measure objective listening ability, as well as four questionnaires that measured subjective self-rated hearing, feelings of loneliness, perceived social support, and depression and anxiety.

Study sample: One-hundred fifteen individuals aged above 60 with no treated hearing loss.

Results: No correlation was found between loneliness scores and subjective self-rated hearing or objective speech-in-noise perception after adjusting demographic variables and overall psychological distress (anxiety and depression). However, self-rated hearing was positively correlated with social support when anxiety/depression scores were low. When anxiety/depression scores were high, this relationship was attenuated. Objective speech-in-noise perception did not correlate with perceived social support.

Conclusions: Self-rated hearing ability positively predicts ratings of social support in older adults with low levels of psychological distress.

Objective: This study assessed the relevance of auditory brainstem response (ABR) thresholds in evaluating cochlear implantation (CI) candidacy by studying their correlation with functional hearing in patients with sensorineural hearing loss (SNHL).

Design and study sample: In this retrospective study, we examined correlations between ABR thresholds, speech perception scores in quiet and pure-tone audiometry in 191 adults. We compared these correlations between individuals with different degrees of SNHL to discern differences in potential CI candidates and individual with less severe SNHL.

Results: A significant negative correlation was found between ABR thresholds and unaided speech perception scores at 70 dB SPL (R = -0.397, P_corr<0.0001). For patients scoring 50% or higher on speech audiometry, a significant correlation was observed (R = -0.604, P_corr<0.004), but not for those scoring less than 50% (R = -0.168, P_corr=0.084). In the subgroup with ABR thresholds better than 60 dB nHL, a moderate correlation was observed (R = -0.575, P_corr = 0.032), which was not significant in patients with ABR thresholds of 60 dB nHL or worse (R = -0.175, P_corr = 0.084).

Conclusions: In patients with severe hearing loss (speech perception <50% or ABR thresholds ≥60 dB nHL), the ABR threshold does not correlate with speech perception, limiting its clinical validity for functional auditory performance or CI candidacy evaluation.

Objectives: The purpose of this study was to investigate a policy-related factor and patient-related factors that might affect hearing aid adoption for adults, specifically price unbundling, and demographic and audiologic factors, respectively.

Design: Retrospective data from hearing aid consultation appointments in an audiology clinic in a medical centre were examined. Appointments were conducted between 2019 and 2023, capturing visits when services and devices were charged using a model that was bundled (2019-2022) and unbundled (2023). In the unbundled model, a separate fee was charged for the consultation appointment.

Study sample: Adults (n = 5186) without hearing aid experience who completed a hearing aid consultation appointment.

Results: After unbundling, a higher percentage of consultation appointments resulted in hearing aid adoptions (increased from 53% to 65%), despite a decline in the number of hearing aid consultation appointments. The absolute number of hearing aid adoptions per provider did not change over time. Also stable were reasons for hearing aid non-adoption; they were primarily related to lack of perceived hearing difficulty.

Conclusions: By unbundling and charging specifically for hearing aid consultation appointments, hearing aid consultations can be made more efficient, decreasing time spent with patients who do not need consultation services without negatively impacting revenue.

Objective: To explore the effects of language on word recognition ability and associated access to cochlear implants in Spanish- and English-speakers with hearing loss.

Design: Retrospective chart review.

Study sample: The study included 1411 English and Spanish-speaking adults with sensorineural hearing loss. Word recognition as a function of pure-tone average was evaluated by test language. Sensitivity and specificity of word recognition testing performed using the NU-6 and Spanish Bisyllables in discriminating between cochlear implant and non-cochlear implant candidates were analysed.

Results: Spanish-speakers had significantly poorer thresholds compared to English-speakers, yet significantly better word recognition, t(2763) = 1.86, p < 0.05. The effect of test language on word recognition increased with increasing hearing loss severity, F(3, 2762) = 6.03, p < 0.001, partial η² = .007. The sensitivity and specificity of word recognition testing were 93% and 74% respectively for Spanish, and 95% and 75%, respectively, for English word recognition tests in meeting referral criteria for cochlear implant evaluation.

Conclusions: Based on classification performance analysis, Spanish and English word recognition measures exhibit comparable effectiveness in referring patients for cochlear implant evaluation. While Spanish-language measures yielded better performance, this does not result in a significant difference in referral rates for Spanish versus English speakers for unaided word recognition scores of 60% or less.