International Journal of Audiology最新文献

Objectives: This systematic review examines spectro-temporal resolution ability in children with cochlear implants (cCI). The objective is to summarise the articles that assess the spectro-temporal resolution ability, its relationship with speech perception, and associated factors in cCI.

Design: A systematic review.

Study sample: A total of 193 articles were reviewed, and seven articles were selected for the systematic review that assessed spectro-temporal resolution ability in cCI. All seven studies used the Spectro-Temporal Modulated Ripple Test (SMRT) to assess spectro-temporal resolution ability.

Results: The results consistently showed that cCI demonstrated lower SMRT thresholds than children with normal hearing. A significant correlation was found between SMRT thresholds and speech perception scores. Factors associated with spectro-temporal resolution included chronological age, age at implantation, duration of implantation, cognitive ability, and the effect of training.

Conclusion: SMRT can be used to assess young children, as it shows a significant correlation with speech perception scores. Even though the results of SMRT thresholds and their correlation with speech perception were consistent, variations in the results were present across studies, which may have been due to demographic and technological factors.

Objective: In this study we investigated whether speech recognition in noise improves with age in children with hearing loss using hearing aids (HA) or cochlear implants (CI). Secondly, we identified the audiological factors that predict these abilities.

Design: We performed a retrospective analysis of the Dutch Digit-In-Noise (DIN) test results from our clinical population of children rehabilitated with HAs (N = 163) or CIs (N = 83). Participants were aged between 6 and 18 years, had stable hearing loss and an open-set phoneme recognition in quiet > 50% at 65 dB SPL.

Study sample: We included 242 measurements from HA users and 190 from CI users. All had at least 1 year of device experience and were using their daily program.

Results: Two linear mixed models were created for HA and CI users. A significant effect of age on speech in noise performance was observed for both groups. For HA users, pure tone average was another significant predictor, for CI users = the modality. Children with bilateral CIs had a significantly better DIN SRT compared to those with unilateral or bimodal rehabilitation.

Conclusions: Age and audiological factors, such as pure tone average and modality, significantly predict speech-in-noise performance in children using HAs or CIs.

Objective: Conduct a systematic review of clinical practice guidelines for sudden sensorineural hearing loss (SSNHL) to identify interventions related to the diagnosis and management of SSNHL. Results from this review will inform the development of the World Health Organisation (WHO) Package for Ear and Hearing Care Interventions (PEHCI).

Design: We searched for clinical practice guidelines, published from 2014 onwards, across four databases and websites for audiology/otolaryngology professional organisations, that report recommendations on diagnosis and management of SSNHL. We assessed the quality of the clinical practice guidelines using the AGREE II tool. All review processes were performed by two independent reviewers.

Sample: Following the screening and quality appraisal, we identified three high-quality clinical practice guidelines relevant to SSNHL.

Results: Specific interventions focused on the (1) diagnosis of SSNHL with clinical tests, (2) management of SSNHL with patient education, medical management with steroid use with hyperbaric oxygen therapy (when warranted), and (3) follow-up in terms of outcomes assessment with clinical tests and accompanied by rehabilitation when warranted.

Conclusions: The clinical practice guidelines detailed recommendations on the diagnosis, management, and follow-up of patients with SSNHL. The interventions derived from these guidelines will inform the selection of interventions for inclusion in the WHO PEHCI.

Objective: To assess the validity, reliability and readability of four AI chatbots for hearing-health information.

Design and study sample: Three audiologists created 100 questions covering adult hearing loss, paediatric hearing, hearing aids, tinnitus and cochlear implants (20 each). Questions were submitted twice to ChatGPT-3.5, Bing AI, Gemini and Perplexity. Answers were scored for factual accuracy and completeness on a five-point Global Quality Score. Validity was defined using low (score = 5) and high (score ≥ 4) thresholds. Internal consistency was estimated with Cronbach's α; readability with the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). All scoring was completed independently by two blinded reviewers; discrepancies were resolved by consensus.

Results: Under the low threshold ChatGPT-3.5 and Perplexity were most valid (84% and 79%); high-threshold validity fell to 37% and 34%. Perplexity had the highest overall reliability (α = 0.83) yet α dropped below 0.70 for cochlear-implant, tinnitus and hearing-aid questions. 84% percent of outputs were "Difficult"/"Very Difficult" and 68% read at college level.

Conclusions: AI chatbots deliver generally accurate hearing-health content, but high-threshold accuracy, domain-specific reliability and readability remain suboptimal. They should supplement, not replace the professional counselling. Continued optimisation and external validation are needed before routine clinical recommendation.

Objective: This study investigated the impact of cognitive function on the administration of the hearTest automated hearing test in older adults. The relationship between Montreal Cognitive Assessment (MoCA) score and three hearTest metrics (false response rate, standard deviation of response time, and test duration) was analysed.

Design: A cross-sectional correlational design was used. Testing was conducted in participants' homes or retirement villages.

Study sample: One hundred and five older adults (aged 67-97 years) receiving home-based aged care with MoCA scores ranging between 5 (possible dementia) and 30 (healthy cognition).

Results: There was no relationship between MoCA score and false response rate (r = -0.12, CI = -0.42 to 0.06, p = 0.22) or standard deviation of response time (r = -0.11, CI = -0.33 to 0.04, p = 0.27). There was a moderate sized correlation between MoCA score and test duration (r = -0.31, CI = - 0.49 to - 0.15, p = 0.001), indicating longer test duration with lower MoCA scores.

Conclusions: hearTest performance is not impacted by cognitive ability in a population of older adults that included people living with dementia. However, additional test time may be needed for hearTest administration for individuals with cognitive impairment.

Objective: To compare the long-term effects of two earplug fit-training methods on the ability of U.S. military personnel to self-fit a foam earplug and achieve sufficient attenuation of weapon noise during military training.

Design: Participants were randomly assigned to one of two earplug fit-training methods (control [typical; n = 239], experimental [experiential hearing protection device (eHPD); n = 151]), and one of two hearing protector fit-testing (HPFT) schedules (quarterly, annually).

Study sample: 390 U.S. Marine Corps Infantry training recruits.

Results: Passing had no association with participants tested quarterly or annually and were merged to two groups for analysis. Immediately post-training, 57% of the control and 78% of the experimental training groups achieved a passing personal attenuation rating (PAR) of at least 25.0 A-weighted decibels. Approximately 12 months post-training, the passing PAR proportion reduced to 19% (control) and 37% (experimental). The differences in pass rates between groups at both time points were statistically significant (p < 0.05).

Conclusions: The individualised eHPD fit-training resulted in a greater proportion of participants able to achieve adequate noise protection (both immediately and one year later) with issued foam earplugs. Based on our study results, the ability to adequately self-fit in-ear hearing protection is a perishable skill and annual training is justified.

Objectives: The COVID-19 pandemic changed working conditions globally, posing specific challenges for individuals with hearing loss related to the change in work-related communication patterns. The aim of this study was to explore the impact of remote work and hearing loss status on well-being and communication before, during, and after the pandemic.

Design: This cross-sectional, retrospective survey utilised a self-administered online questionnaire addressing well-being and communication at work, both social and work-related.

Study sample: The sample included 220 adults (aged 18-89) who worked during the pandemic and had self-reported, diagnosed, or perceived, hearing loss.

Results: Remote work was associated with fewer communication challenges compared to on-site work across the sample. While general well-being declined across the sample during the pandemic, a post-pandemic increase was observed in individuals with diagnosed hearing loss using hearing aids and those with perceived hearing loss, but not in individuals with diagnosed hearing loss who did not use hearing aids.

Conclusions: These findings point to two key needs: 1) Flexible work models that reduce communication barriers, and 2) increased implementation of hearing aids and broader support systems to maintain well-being under challenging conditions. Future workplace guidelines should consider both the communication and psychosocial dimensions of hearing accessibility.

Objective: Styrene is a known ototoxic drug, causing increased oxidative stress and inflammation in cochlear structures. The aim of this study is exploring the possible involvement of NRLP3 inflammasome in mediating the interplay between oxidative stress and inflammation in a model of styrene ototoxicity and to compare the effectiveness of two therapeutic strategies.

Design: Styrene was administered 400 mg/kg, 5 days a week for 3 consecutive weeks in Wistar rats. An antioxidant (rosmarinic acid, 10 mg/kg), and an anti-inflammatory (anakinra, 30 mg/kg) drugs were used to evaluate the protective effects on auditory function. At the end of treatments functional, morphological and molecular analyses were used to study the mechanisms underlying ototoxicity and otoprotection. Study sample: 66 male adult Wistar rats. Results: Both antioxidant and anti-inflammatory treatments significantly reduced oxidative stress, NLRP3 inflammasome activation, and inflammatory markers. However, anakinra provided the best protective effect, with earlier hearing recovery and greater suppression of inflammation.

Study sample: 66 male adult Wistar rats of 2 months of age.

Results: Functional and molecular analyses revealed that both treatments significantly reduced oxidative stress, NLRP3 inflammasome activation, and inflammatory markers. However, anakinra provided the best protective effect, as evidenced by earlier auditory threshold recovery and greater suppression of inflammation. These findings underscore the pivotal role of inflammation in styrene-induced ototoxicity, highlighting NLRP3 inflammasome activation as a central mediator linking oxidative and inflammatory damage.

Conclusions: Our results suggest that targeting inflammation provides a more comprehensive and timely intervention for styrene ototoxicity. The dual mechanism of action of anakinra (reducing NLRP3 levels and directly modulating IL-1β) makes it a promising candidate for mitigating cochlear damage caused by environmental and toxic insults.

Objective: To develop the Slovenian DIN test using synthetic speech and digit-equalisation via an automatic speech recognition system, and to evaluate the test.

Design: The Aladdin procedure was used to develop the Slovenian DIN. A repeated measures design was used to measure speech recognition thresholds (SRTs) with three antiphasic DIN tests and two diotic DIN tests.

Study sample: Twenty-eight listeners with normal hearing and 62 listeners with hearing loss.

Results: There was a learning effect for the initial test but no further improvement in SRT with subsequent tests. The standard error of measurement (SEM) for listeners with normal hearing was 0.9 and 0.7 dB for the antiphasic and diotic DIN tests, respectively. Hearing screening characteristics were excellent.

Conclusions: The newly developed Slovenian DIN test has high precision, expressed by a small SEM, and stimulates the implementation in clinical practice. It can also be used for hearing screening with associated cut-off values.

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.