International Journal of Audiology最新文献

Objectives: Monothermal caloric testing (MCT) shows potential as a screening method in vestibular assessment; however, the optimal stimulus modality and diagnostic threshold remain unclear. This study aimed to identify, within a single investigation, the most effective stimulus type (air or water; warm or cool) and the optimal cut-off threshold (15% or 25%) for maximising the diagnostic performance of MCT.

Design: Retrospective study.

Study sample: Bithermal caloric test (BCT) results from 202 adults (103 water, 99 air) were analysed. MCT results were assessed at 15% and 25% thresholds based on sensitivity, specificity, and overall diagnostic accuracy, using BCT as the reference standard.

Results: Warm stimuli demonstrated higher sensitivity, with warm air yielding the highest value (86.7%), while cool stimuli showed greater specificity, with cool water reaching the highest specificity (78.7%) at the 25% threshold. Warm air MCT resulted in the lowest false negative rate (6%) and highest diagnostic accuracy (94%), reducing the need for BCT to 57.6% of patients. Lowering the threshold to 15% slightly improved accuracy (95.9%) but increased BCT referrals (64.6%).

Conclusions: Warm air MCT appears to be an efficient screening tool for detecting unilateral vestibular weakness, offering high diagnostic accuracy while potentially reducing the need for comprehensive BCT.

Objective: This study investigated the speech performance with and user acceptance of the Cochlear™ Nucleus^® 8 Sound Processor, with a particular focus on the automatic activation of the noise reduction feature, ForwardFocus (FF), in the new SCAN 2 program (SCAN 2 FF).

Design: Prospective, single-site, open-label within subject interventional study (NCT05080283).

Study sample: Twenty adult (>18 years of age) cochlear implant recipients with at least 6 months of experience with their cochlear implant system.

Results: There was a significant and clinically meaningful decrease (improvement) in SRT of 4.3 and 4.2 dB with the SCAN 2 FF program compared to the SCAN 2 program in the S0Nrearhalf and S0N3 configurations, respectively (both p < 0.001). Scores on the Speech Spatial and Qualities of Hearing Scale (SSQ12) were comparable between the Nucleus 7 and Nucleus 8 Sound Processors. Most participants provided positive subjective evaluations of the SCAN 2 FF program and the overall Nucleus 8 Sound Processor following take-home use.

Conclusion: The SCAN 2 FF program on the Nucleus 8 Sound Processor offers cochlear implant recipients a clinically meaningful benefit for speech recognition in noise.

Objective: Existing evidence regarding the ways in which people with hearing loss respond to listening difficulty in verbal conversation is fragmented. To advance understanding of the experience of listening difficulty in in-person verbal conversation, this review seeks to map the current evidence, focusing on behavioural and affective responses.

Design: Scoping review following PRISMA-ScR guidelines. Articles were identified through systematic searches in five reference databases, and through reference checking. Thematic synthesis was used to collate and condense data into distinct themes and categories.

Study sample: Literature examining adults' behavioural, and/or affective responses to listening difficulty in in-person conversation.

Results: The literature search identified 8503 studies, and 81 were selected for inclusion. Responses from people with hearing loss, people with normal hearing, and communication partners were identified, and were assembled into five themes, each consisting of multiple categories.

Conclusion: People with hearing loss and their communication partners respond to listening difficulty in conversation in a wide range of ways, covering diverse aspects of communication. People with normal hearing report most of the same response types as people with hearing loss. Nevertheless, there is a paucity of evidence regarding responses of people with normal hearing, indicating a need for more comparative studies.

Objective: To investigate the impact of Meniere's Disease (MD) on balance and proprioception by utilising multi-frequency Vestibular Evoked Myogenic Potentials (VEMP) to evaluate otolith function.

Design: Observational study employing the Otolith Tuning Index (OTI) to quantify vestibular function through analysis of VEMP response rates and tuning ratios.

Study sample: A total of 123 participants were included, comprising 94 patients diagnosed with MD and 29 healthy controls. VEMP testing was conducted at frequencies of 500 Hz, 750 Hz, and 1 kHz.

Results: Among MD patients, 69% reported imbalance, with severe cases predominating in advanced stages. The non-response rate for oVEMP at 500 Hz was 73.3% on the affected side, associated with unpredictable falls. Significant correlations were observed between cVEMP non-responses and both disease severity (p = 0.012) and walking imbalance (p = 0.037). oVEMP responses were lowest at 500 Hz, improving at 1 kHz, whereas cVEMP amplitudes peaked at 500 Hz bilaterally. OTI values indicated significant otolith dysfunction on affected sides compared to contralateral sides and controls (p = 0.026, p = 0.032, p < 0.001), with dysfunction worsening with disease progression and age.

Conclusions: The Otolith Tuning Index (OTI) effectively measures otolith dysfunction in MD patients, offering valuable insights to enhance diagnostics, patient management, and treatment planning.

Objective: To propose the application of Keyes's Model of Social Wellbeing to guide hearing care professionals (HCPs) in providing social coaching to address the impact of hearing loss on social wellbeing in older adults.

Design: A discussion paper introducing Keyes's Model of Social Wellbeing and its application in enhancing the social wellbeing of older adults with hearing loss. Qualitative insights and evidence from various studies are provided to support the application of the proposed model. Examples of how HCPs can use social coaching to help address the effects of hearing loss on social coherence, integration, acceptance, contribution, and actualisation are provided.

Study sample: N/A.

Results: Hearing loss significantly impacts all five constructs of Keyes's Model of Social Wellbeing, leading to challenges in social coherence, integration, acceptance, contribution, and actualisation. Effective social coaching by HCPs can mitigate these impacts by providing tailored support, enhancing communication skills, and fostering a sense of belonging and purpose.

Conclusions: Integrating social coaching into audiology practice and policy, guided by Keyes's Model, can improve social wellbeing for older adults with hearing loss. This person-centred approach requires HCPs to understand the social implications of hearing loss and deliver targeted interventions to support their clients' social and emotional needs.

Objective: Equitable access to hearing aids and related services remains a global health challenge, particularly in resource-limited settings. A major barrier to access is the lack of diagnostic and rehabilitative services, which is substantially attributable to the persistent shortage of ear and hearing care specialists. This discussion article provides an overview of limitations in the ear and hearing care workforce, the relevance of task sharing to ear and hearing care, and a new, evidence-based World Health Organization (WHO) technical resource aimed at improving access to hearing aids worldwide.

Design and study sample: A synthesis of current research and expert opinion.

Results: First, this article describes the global shortage of qualified ear and hearing care specialists. Next, it describes how community-based care, supported by task sharing among trained non-specialist providers and qualified ear and hearing care providers, could overcome these workforce limitations, and describes the critical role of qualified ear and hearing care providers in task sharing. Finally, this article provides an overview of a WHO resource which provides practical information for hearing aid service provision in resource-limited settings.

Conclusion: Innovative strategies to expand the ear and hearing care workforce are essential to advance efforts towards equitable access to hearing aids and related services.

Objective: To evaluate audiological and nonaudiological predictors of hearing aid (HA) uptake in patients with unilateral hearing loss (UHL) and bilateral hearing loss (BHL).

Design: Retrospective study.

Study samples: A total of 655 patients with UHL and 3,699 patients with BHL were retrospectively included over a 10-year period. The primary audiological measurements were 4-frequency average pure-tone audiometry, speech discrimination score, hearing loss type, and presence of tinnitus.

Results: The HA uptake rates in patients with UHL and BHL were 28.4% and 45.0%, respectively. In the UHL group, no substantial differences were identified between the HA uptake and refusal groups, except for sex. In contrast, the BHL group showed significant differences based on age, sex, and hearing threshold.The significant associations between potential explanatory variables and HA uptake were observed for age, SDS, and tinnitus, with odd ratios of 1.015, 1.004, and 1.251, respectively. The predictive accuracy (discriminating power) was 52.0% for UHL and 55.9% for BHL.

Conclusions: The statistical analysis of this study indicates that audiological predictors accounted for approximately 50% of the impact on HA uptake. Our findings underscore the importance of considering nonaudiological factors during counselling to enhance HA uptake.

Objective: Tinnitus and its pathophysiological mechanisms need more investigation because tinnitus may change the typical processing of sounds in the auditory system. Poor temporal resolution, which is not assessed with conventional subjective tinnitus evaluations, has been reported in some tinnitus sufferers.

Design: This study used a gap-in-noise paradigm to assess temporal resolution in tinnitus sufferers using both behavioural and electrophysiologic methods.

Study sample: 19 participants with unilateral tinnitus and a control group without tinnitus participated in this study. Both wide-band and narrow-band signals were used to investigate the temporal resolution of the whole auditory system and at different frequency regions respectively.

Results: The results of this study suggest that individuals with tinnitus exhibit poorer-than-normal temporal resolution with both methods especially approaching tinnitus pitches. There was a strong positive association between behavioural and electrophysiological measurements when narrow-band stimuli were used. There was no difference between the acuity of temporal resolution in the tinnitus and the non-tinnitus ears of tinnitus sufferers.

Conclusions: This study showed the combination of behavioural and electrophysiological methods may overcome the limitations of psychological methods in the detection of tinnitus pitch. More effective identification of tinnitus pitch could be an important step towards better tinnitus management.

Objective: The majority of individuals with hearing loss worldwide reside in low- and middle-income countries (LMICs), but there is limited information regarding the characteristics of hearing loss in these regions. This descriptive study aims to address this knowledge gap by analysing audiogram patterns in LMIC populations. Greater knowledge about the properties of hearing loss in LMICs allows for improved planning of interventions.

Study sample: Retrospective data from 23 collaborating centres across 16 LMICs were collected. All participants were adults seeking help for hearing problems. A machine learning approach was utilised to classify the hearing threshold data and identify representative profiles. The study comprised 5773 participants.

Results: The results revealed mildly sloping audiometric patterns with varying severity. The patterns differed from previous studies conducted in high-income regions which included more steeply sloping losses. The findings also indicated a higher proportion of more severe levels of hearing loss.

Conclusions: These variations could be attributed to population-level differences in the causative mechanisms of hearing loss in LMICs, such as a higher prevalence of infectious disease-related hearing loss. The results may also reflect differences in health seeking behaviours. This study highlights the need for tailored, scalable, hearing interventions for LMICs.