Audiology Research最新文献

Background/Objectives: This study explored how attribute framing (lifestyle-focused vs. technology-focused product descriptions) and popularity cueing (presence or absence of a "best-seller" label) influenced purchase likelihood for a fictitious selection of hearing aids (HAs) among Canadian adults aged 40 years and above. The study further aimed to investigate whether the effects observed were unique to HAs or applicable to less-specialized consumer technology contexts. Method: A 2 × 2 × 2 mixed experimental design compared attribute framing and popularity cueing effects across HAs and notebook computers at three technology levels (entry-level, midrange, and premium). Participants (n = 122) provided ratings indicating their purchase likelihood for each product. Results: Attribute framing showed no significant influence on purchase decisions across technology levels. The presence of a popularity cue that the midrange HA was the best-seller negatively affected purchase likelihood for the entry-level HA, with higher purchase likelihood ratings observed when this cue was absent. Participants expressed stronger purchase likelihood for premium HAs compared to premium notebook computers. Notably, these two effects were not statistically significant following correction for multiple comparisons. Conclusions: Popularity cues for HAs may have inadvertent consequences for consumer perceptions of models with differing technology levels. Findings also suggest potentially greater willingness to invest in premium health-related technologies versus familiar consumer technology. Further research involving current HA users or candidates is needed to better understand these findings.

Background/Objectives: Vestibular migraine (VM) is one of the most prevalent causes of episodic vertigo, yet it remains underdiagnosed due to overlapping features with other vestibular disorders and the absence of definitive diagnostic tests. Vestibular evoked myogenic potentials (VEMPs) assess otolith and vestibular nerve function and may help identify pathophysiological mechanisms in VM. This systematic review aimed to evaluate the usefulness of VEMP in understanding VM, synthesize existing findings, and explore its clinical implications. Method: A systematic search was performed in PubMed, ProQuest, Scopus, Web of Science, and EMBASE up to 2025 following PRISMA guidelines. Studies were included if they assessed cVEMP and/or oVEMP in patients diagnosed with VM using established clinical criteria. Data extraction and quality assessment were conducted independently by three reviewers using Cochrane and Joanna Briggs Institute tools. A total of 2578 titles and abstracts were screened, and 28 studies met the inclusion criteria. Results: Across 28 studies, 23 reported VEMP abnormalities in VM. The most frequent findings were reduced amplitudes and increased asymmetry ratios compared to healthy controls, indicating potential otolithic dysfunction. Latency prolongations were less consistently reported. Differences between cVEMP and oVEMP findings in individuals with VM suggested variable involvement of saccular and utricular pathways, with oVEMP abnormalities appearing more prominent. Conclusions: VEMP testing reveals subtle vestibular dysfunction in VM, primarily reflected in reduced amplitude and altered asymmetry ratios. However, the association between VEMP abnormality and VM is inconclusive, specifically due to heterogeneity among the included studies. Although findings support its potential as a diagnostic adjunct, methodological variability (including variability in patient recruitment) underscores the need for standardized VEMP protocols to enhance diagnostic accuracy and comparability across studies.

Background/Objectives: This study compared vestibular evoked myogenic potentials (VEMP) and video head impulse test (vHIT) findings between long-term hearing aid users and non-users with moderately severe to profound sensorineural hearing loss (SNHL) to investigate whether prolonged use of high-power hearing aids has any effect on the functioning of peripheral vestibular organs. Methods: A cross-sectional study was conducted in the audiology clinic of a tertiary care hospital. Using convenience sampling, 67 adults aged 20-64 years who visited for hearing evaluation or hearing aid services were recruited and allocated into hearing aid user and non-user groups. VEMP latency and amplitude and vHIT vestibulo-ocular reflex (VOR) gain values were compared between groups. Multiple linear regression was performed to examine the association between the duration of hearing aid use and vestibular function. Results: No significant group differences were observed for any VEMP or vHIT parameter, except for the latency of P1 of the cVEMP in the left ear. Regression analyses indicated that the duration of hearing aid use was not significantly associated with any vestibular test measure. Conclusions: Long-term use of high-power hearing aids does not appear to be associated with measurable alterations in vestibular function. Nonetheless, longitudinal studies with improved control of confounding variables are recommended to validate these preliminary findings.

Dysphagia and dysarthria are common, co-occurring manifestations in neurodegenerative diseases, resulting from damage to distributed neural networks involving cortical, subcortical, cerebellar, and brainstem regions. These disorders profoundly affect patient health and quality of life through complex sensorimotor impairments. Objective: The aims was to provide a comprehensive, evidence-based review of the neuroanatomical substrates, pathophysiology, diagnostic approaches, and management strategies for dysphagia and dysarthria in neurodegenerative diseases with emphasis on their multisystem nature and integrated treatment approaches. Methods: A narrative literature review was conducted using PubMed, Scopus, and Web of Science databases (2000-2024), focusing on Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA). Search terms included "dysphagia", "dysarthria", "neurodegenerative diseases", "neural networks", "swallowing control" and "speech production." Studies on neuroanatomy, pathophysiology, diagnostic tools, and therapeutic interventions were included. Results: Contemporary neuroscience demonstrates that swallowing and speech control involve extensive neural networks beyond the brainstem, including bilateral sensorimotor cortex, insula, cingulate gyrus, basal ganglia, and cerebellum. Disease-specific patterns reflect multisystem involvement: PD affects basal ganglia and multiple brainstem nuclei; ALS involves cortical and brainstem motor neurons; MSA causes widespread autonomic and motor degeneration; PSP produces tau-related damage across multiple brain regions. Diagnostic approaches combining fiberoptic endoscopic evaluation, videofluoroscopy, acoustic analysis, and neuroimaging enable precise characterization. Management requires multidisciplinary Integrated teams implementing coordinated speech-swallowing therapy, pharmacological interventions, and assistive technologies. Conclusions: Dysphagia and dysarthria in neurodegenerative diseases result from multifocal brain damage affecting distributed neural networks. Understanding this multisystem pathophysiology enables more effective integrated assessment and treatment approaches, enhancing patient outcomes and quality of life.

Introduction: The aim of this study was to determine the position of otoconial debris in lateral ampullar or non-ampullar canalolithiasis, based on two parameters: (1) the direction of the nystagmus appearing when the patient lies down, if present, and (2) the positional nystagmus evoked by the supine roll test. Methods: Theoretical results were compared with a population of 170 patients observed over the past ten years for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The series included 141 geotropic and 29 apogeotropic cases. Results: Among the geotropic forms, 80 showed no supine nystagmus (Geotropic Nystagmus with no supine nystagmus, GT0) (56.7%), 51 had supine nystagmus directed toward the healthy side (Geotropic Nystagmus with supine nystagmus congruent, direct toward the healthy side, GT+) (36.2%), and 10 toward the affected side (Geotropic Nystagmus with supine nystagmus incongruent direct to the affected side, GT-) (7.1%). In the apogeotropic group, 10 showed no supine nystagmus (Apogeotropic nystagmus with no supine nystagmus, AGT0) (34.6%), 16 had nystagmus toward the affected side (Apogeotropic Nystagmus with supine nystagmus congruent, direct toward the affected side, AGT+) (55.2%), and 1 toward the healthy side (Apogeotropic Nystagmus with supine nystagmus Incongruent, direct toward the healthy side, AGT-) (3.4%). Two cases presented monopositional apogeotropic nystagmus (mAGT), consistent with a "sieve-type canal jam" (6.8%). Overall, 90 out of 170 patients (52.9%) showed no nystagmus in the supine position, with a statistically significant difference between variants (p = 0.0474, Yates correction). Conclusions: The comparison between lying-down nystagmus and positional nystagmus, assessed through the Supine Roll Test as the leading diagnostic maneuver for horizontal canal involvement, may help identify the initial location of debris within the lateral semicircular canal and guide the appropriate liberatory maneuver, while the effectiveness and side of the maneuver allow the distinction between canal-side and utricular-side jams.

Background/Objectives: Patients with Idiopathic sudden sensorineural hearing loss (ISSNHL) are often devastated by the unknown etiology coupled with the unknown pathway to recovery. The aim of this study was to evaluate whether abnormalities on the video Head Impulse Test (vHIT) performed early in the course of ISSNHL are associated with poorer hearing recovery. Methods: Forty-four patients with ISSNHL were prospectively enrolled between 2019 and 2022 following exclusion of differential diagnoses on clinical and MRI evaluation. vHIT was performed within 1-14 days of symptom onset and within 48 h of hospitalization. Recovery at six months was assessed both as a dichotomous outcome and by change in pure tone average (PTA). Group differences were analyzed using Fisher's exact and Mann-Whitney U tests. A two-predictor logistic regression model examined the association between vHIT results, dizziness, and recovery. Results: Twelve patients exhibited abnormal vHIT findings. Abnormal vHIT was strongly associated with the presence of dizziness and with markedly poorer hearing recovery at six months. Patients with normal vHIT demonstrated substantially greater improvement in PTA thresholds compared with those showing abnormal results. Logistic regression further confirmed that abnormal vHIT was an independent predictor of reduced likelihood of hearing recovery, whereas dizziness alone did not independently influence outcomes. Conclusions: Our findings suggest that abnormal vHIT results in ISSNHL patients are linked to poor hearing recovery, which can enhance patient counseling regarding expectations. Although promising as a prognostic tool, we acknowledge our limited sample size and recommend validation in larger prospective cohorts.

Research exploring the impact of stimulation rate modifications on perception in cochlear implant users continues to expand. The existing body of research remains contradictory, making it difficult to establish a clear consensus that could inform clinical recommendations. In this context, this article aims to question the usefulness of such adjustments as a clinical intervention beyond the initial fitting, particularly for optimizing non-speech processing. To do so, we combined an overview of the existing literature on the effects of stimulation-rate changes on speech and non-speech processing with a discussion of observational data. The current evidence base is sparse, often contradictory, and affected by interoperability challenges that limit cross-study comparability. Consequently, it is not possible to formulate robust, evidence-based clinical recommendations at this time. Clinicians should be cautious about implementing stimulation-rate adjustments beyond the initial fitting and should wait for more robust evidence to emerge before considering such changes.

Background and Clinical Significance: Vestibular disorders in children are often overlooked, delaying treatment. Early diagnosis of benign paroxysmal positional vertigo (BPPV) allows for targeted maneuvers during acute episodes. Though rare, BPPV can occur in children due to stereocilin gene (STRC) deletions or variants, causing hearing loss and vestibular dysfunction. Case Presentation: This study highlights a case of recurrent vertigo linked to a homozygous deletion on chromosome 15 affecting the STRC gene.

Background/Objectives: Retrocochlear auditory dysfunctions (RADs), including auditory neuropathy (AN) and auditory processing disorders (APD), encompass disorders characterized by impaired auditory processing beyond the cochlea. This narrative review critically examines their distinguishing features, synthesizing recent advances in classification, pathophysiology, clinical presentation, and treatment. Methods: This narrative review involved a comprehensive literature search across major electronic databases (e.g., PubMed, Scopus) to identify and synthesize relevant studies on the classification, diagnosis, and management of AN and APD. The goal was to update the view on etiologies (genetic/non-genetic) and individualized rehabilitative strategies. Diagnosis relies on a comprehensive assessment, including behavioral, electrophysiological, and imaging tests. Rehabilitation is categorized into bottom-up and top-down approaches. Results: ANSD is defined by neural desynchronization with preserved outer hair cell function, resulting in abnormal auditory brainstem responses and poor speech discrimination. The etiologies (distal/proximal) influence the prognosis for interventions, particularly cochlear implants (CI). APD involves central processing deficits, often with normal peripheral hearing and heterogeneous symptoms affecting speech perception and localization. Rehabilitation is multidisciplinary, utilizing bottom-up strategies (e.g., auditory training, CI) and compensatory top-down approaches. Remote microphone systems are highly effective in improving the signal-to-noise ratio. Conclusions: Accurate diagnosis and personalized, multidisciplinary management are crucial for optimizing communication and quality of life. Evidence suggests that combined bottom-up and top-down interventions may yield superior outcomes. However, methodological heterogeneity limits the generalizability of protocols, highlighting the need for further targeted research.

Background: The objective assessment of hearing in non-cooperative populations, such as neonates, remains a challenge. While Brainstem Evoked Response Audiometry (BERA) is the gold standard, its sensitivity to motion artifacts necessitates alternatives.

Objective: This scoping review maps the current literature on functional near-infrared spectroscopy (fNIRS) as a supplementary method in objective audiometry.

Data synthesis: fNIRS shows potential to detect cortical hemodynamic responses, particularly to complex stimuli like speech, which BERA cannot fully assess. Key advantages include motion tolerance and suitability for pediatric and cochlear implant populations. However, the literature reveals significant heterogeneity in stimulation protocols and data processing. Evidence suggests fNIRS is better suited for assessing higher-level auditory processing rather than replacing BERA for threshold estimation.

Conclusions: fNIRS is a promising complementary tool. However, due to the lack of standardized protocols and large-scale validation studies, it is not yet a direct clinical replacement for BERA. Future work must focus on protocol standardization and establishing robust normative data.