Audiology Research最新文献

Background/Objectives: The voice is often perceived as a natural and spontaneous means of communication, but it involves complex interactions among physiological, psychological, and environmental factors. For teachers, whose profession relies heavily on vocal use, understanding and managing vocal strain is crucial. This study investigates the correlation between ambient noise levels in classrooms and teachers' self-assessed voice-related quality of life, as measured by the Voice Handicap Index (VHI). The focus is on how classroom acoustics affect vocal health, considering the high incidence of vocal fatigue among educators. Methods: A pilot exploratory study was conducted from September 2022 to November 2022 involving four primary school teachers (two language and two science) from an Italian primary school. Classroom noise levels were recorded using the "Listen Responsibly" app at intervals during lessons. Following each lesson, teachers completed the VHI questionnaire to evaluate their voice-related quality of life. Statistical analyses included simple and multiple linear regressions, logistic regression, and Spearman's correlation to assess the relationships between noise levels and VHI scores. Results: The study yielded 60 observations categorized into VHI Grade 1 (0-30) and Grade 2 (31-60). Significant differences were observed in average noise levels between these groups, with Grade 2 exhibiting higher noise levels (p < 0.0001). Simple and multiple linear regression analyses confirmed a positive correlation between average recorded noise and VHI scores, with each unit increase in noise associated with a 0.72 unit increase in VHI score (p < 0.0001). Logistic regression identified average recorded noise > 59.5 dB as a significant predictor of higher VHI grades (p < 0.0001). Spearman's correlation confirmed a strong positive correlation (ρ = 0.77, p < 0.01). Conclusions: The study demonstrates a significant relationship between increased classroom noise levels and worse voice-related quality of life among teachers. These findings highlight the need for improved acoustic management in schools to reduce vocal strain. Implementing noise reduction strategies and enhancing classroom acoustics can help mitigate vocal health issues among educators, ultimately improving their professional and personal well-being.

Purpose: Decentralized hearing care models facilitated by community health workers (CHWs) can improve access to care in low-income settings. Preset hearing aids, which offer user-selectable pre-developed amplification programs, may support such models, but little is known about their real-world use and alignment with clinical recommendations.

Method: This longitudinal study formed part of a feasibility project implementing the World Health Organization's (WHO's) hearing aid service delivery approach in three low-income South African communities. Adults (≥18 years) with confirmed moderate-to-severe bilateral hearing loss were fitted with preset hearing aids by trained CHWs. Devices offered four preset amplification programs. Participant-driven selections were recorded at four distinct time points: fitting and follow-ups at 2 weeks, 2 months, and 6 months post-fitting.

Results: In total, 36 participants (mean age = 76 years, SD = 8.9, range 50-96) were fitted with devices. Although over half (right: 52.8%, left: 58.3%) presented with high-frequency loss, only 34% initially selected the corresponding program. Most participants (80.6%, n = 29) changed their selections at least once over the six months. Significant associations between hearing loss configuration and selection occurred at some time points only in the left ear, but agreement with clinically recommended programs declined from 42% at baseline to 28% at six months.

Conclusions: CHW-facilitated hearing aid delivery supports user autonomy in low-resource settings. However, frequent changes and divergence from clinically recommended programs suggest reliance on user-driven trial-and-error adjustments rather than audiometric fit, which may limit long-term benefit. Ongoing, person-centred guidance is needed for the effective use of preset hearing aids.

Objectives: Hearing aids (HAs) are the most common intervention recommended for hearing loss (HL). Many adults with HL do not seek HA rehabilitation. Several studies have attempted to identify barriers and facilitators to using HAs. Different bureaucratic processes for acquiring HAs may lead to different barriers and facilitators. In addition, studies have not yet explored the factors influencing compliance with a recommendation for an HA consultation. This study focuses on the stage prior to consultation in a context where HAs are heavily subsidized. Methods: 148 patients who had undergone a hearing test during 2022 at Hadassah University Medical Center and received a recommendation to undergo a hearing aid consultation were contacted for a telephone survey. Seventy-two adults, 48 male and 24 female, aged 25-85 years, with HL ranging from slight to profound, responded to a telephone questionnaire. The questionnaire, based on two previously published English questionnaires and translated and adapted into Hebrew, was used to assess the main reasons a person did or did not comply with the recommendation to pursue an HA consultation. Results: HL was more severe in those who sought hearing rehabilitation. The main reasons for seeking hearing rehabilitation are the need and desire to hear better and pressure from others. The foremost reasons for not pursuing hearing rehabilitation are feeling that there is currently no need, esthetics, lack of time, and self-consciousness. No significant gender- or age-based differences were found. Conclusions: There are additional barriers to seeking HAs aside from cost and accessibility. Understanding the reasons for avoidance of hearing rehabilitation may help in developing strategies that encourage people to seek hearing rehabilitation and use HAs when the need exists.

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Background: hearing loss represents, today, one of the most significant health problems affecting the world's population. This clinical condition, particularly manifest in adulthood, can arise or be aggravated by both the presence of specific pathologies and by taking multiple classes of drugs at the same time.

Methods: to understand this relationship, the present non-interventional observational study aimed to investigate the relationship between worsening hearing abilities in 1651 patients aged between 18 and 99 years. In particular, the thorough history of patients allowed us to evaluate the pathological profiles, pharmacological profiles, and therapeutic regimens adopted. This allowed us to evaluate its association with self-reported hearing loss, assessed through the administration of the HHIE-S-It questionnaire. Furthermore, given the presence of multimorbidity, the possible correlation between self-reported hearing loss and the specific classes of drugs, categorized using the Anatomical Therapeutic Classification (ATC) system, was evaluated.

Results: the results highlighted how patients taking drugs, both in mono- and polytherapy regimens, had higher hearing deficits than patients not taking drugs. Furthermore, an apparent dose-response effect, in which the risk of moderate to severe impairment progressively increased with the number of drugs taken, was also observed. Different classes of drugs, particularly those used for the treatment of diseases of the cardiovascular system, as well as drugs for acid-related disorders, were significantly linked to an increased risk of perceived hearing impairment. On the contrary, agents belonging to the antidiabetic category have proven to be drugs capable of offering a potential protective effect.

Conclusion: this study highlighted how both the number of drugs taken and some specific categories of drugs can contribute to perceived hearing impairment. While this evidence highlights the importance of integrating audiological evaluation into the management of patients in polypharmacy, the cross-sectional nature of the design precludes the inference of causality. This evidence still favors safer and more personalized therapeutic strategies.

Background/Objectives: This study aimed to linguistically and culturally adapt the Social Participation Restrictions Questionnaire (SPaRQ) and the Hearing Handicap Inventory (HHI) for the Elderly/Adults to Danish and to investigate the reliability and validity of the questionnaires and their subscales in a clinical population. These questionnaires are quantifiable self-assessment tools that are used internationally to evaluate the social-emotional impacts of hearing impairment. Methods: The translation and cross-cultural adaptation procedures followed recommendations to adapt hearing-related questionnaires for different languages and cultures. In total, 64 participants (43 hearing aid users and 21 hearing aid candidates) completed both questionnaires using a test-retest paradigm. Results: Reliability analysis showed good internal consistency (Cronbach's alpha between 0.82 and 0.94) and good agreement between the test and retest rounds (intraclass correlation values between 0.79 and 0.88) with both questionnaires. Neither SPaRQ nor HHI were correlated with better-ear PTA. However, SPaRQ and HHI, as well as their subscales, were significantly correlated with each other. Significant differences were observed at baseline between the HA users and candidates in terms of the better-ear PTA, but the distributions of subscale scores were broad and overlapping. Conclusions: The Danish version of SPaRQ is a reliable instrument for measuring the subjective impacts of hearing impairment. It can be used to capture the experiential aspects of hearing impairment that are not necessarily captured with objective measures of hearing.

Purpose: This study aimed to evaluate retrospectively self-reported changes in tinnitus severity and distress associated with the COVID-19 pandemic and vaccination using validated self-report instruments. It further explored patient-reported onset of tinnitus following vaccination, gender differences in symptom severity, and associations with psychological distress. Method: A cross-sectional online survey was completed by 189 adults between December 2023 and April 2024. Participants retrospectively self-reported tinnitus onset and severity before, during, and after the COVID-19 pandemic using the Tinnitus Handicap Inventory (THI) and the Tinnitus Reaction Questionnaire (TRQ). Additional items assessed COVID-19 vaccination history, infection status, and adverse vaccine reactions. Repeated measures ANOVAs and chi-square tests were used to examine retrospectively reported longitudinal changes and group differences. Results: Mean THI scores increased significantly over time-before (M = 9.57, SD = 16.00), during (M = 29.97, SD = 32.30), and currently (M = 36.92, SD = 28.04)-with large effect sizes across functional, emotional, and catastrophic subscales (p < 0.001). TRQ scores also were reported to rise from before (M = 7.86, SD = 15.29) to during (M = 26.38, SD = 29.58) and remained elevated at the current time (M = 29.79, SD = 24.00), p < 0.001. Approximately 25.9% and 27.0% of respondents reported new or worsened tinnitus after the first and second vaccine doses, respectively. No significant gender differences in symptom severity were observed. TRQ severity classification revealed a marked shift, with moderate or greater distress increasing from 5.8% (before) to 35.6% (current). Conclusions: Retrospective self-reports indicated that tinnitus burden significantly increased during the COVID-19 pandemic and remained elevated at the time of survey completion. A notable proportion of individuals reported new-onset tinnitus following vaccination, though causality cannot be inferred. These findings highlight the need for continued monitoring and comprehensive care addressing both audiological and psychological components of tinnitus.

Background: Spinal Muscular Atrophy type 1 (SMA type 1) is a genetic neuromuscular disease that typically presents before 6 months of age and is characterized by profound hypotonia, progressive muscle weakness, and early involvement of respiratory and bulbar musculature. Swallowing impairment (dysphagia) is a hallmark of SMA type 1 and significantly contributes to morbidity. Despite the documented benefits of disease-modifying therapies (DMTs) in terms of enhanced survival and motor outcomes, their impact on swallowing remains understudied.

Aim: This study aims to longitudinally characterize swallowing function in children with SMA type 1 treated with DMTs, while contextualizing these findings in relation to the patients' current motor abilities and cognitive performance.

Materials and methods: A single-center, longitudinal, observational study was conducted at IRCCS Besta, Milan, Italy, from 2021 to 2025. Swallowing function was evaluated using four validated scales (MAS, OrSAT, FILS, and p-FOIS), while motor and cognitive functions were assessed using CHOP-INTEND and age-appropriate cognitive tests (DQ/IQ). Patients were stratified by baseline swallowing status, pharmacological therapy, and age at DMT administration. Non-parametric statistical tests were applied.

Results: No statistically significant changes in swallowing function were observed over one year in the overall cohort or its subgroups, despite significant improvements in motor function. MAS/e, FILS, and p-FOIS showed moderate associations with CHOP-INTEND and DQ/IQ scores.

Conclusions: Swallowing function in children with SMA type 1 remained largely stable, while motor function significantly improved over one year, regardless of baseline swallowing status, DMT type, and age at administration. These findings underscore the need for standardized, longitudinal assessments of swallowing, motor, and cognitive functions in the management of SMA type 1.

Introduction: Noggin encoding (NOG) gene plays a critical role in early embryogenesis and development of bones, joints, cartilage, eyes, and neural tissue. The NOG gene encodes the noggin protein. Noggin is the only secreted inhibitor of bone morphogenetic protein (BMP) that is associated with abnormal phenotypes in humans. The most commonly observed manifestations of NOG gene mutations include bilateral conductive hearing loss, proximal symphalangism, broad thumbs, hyperopia, and a distinct facial appearance. This genetic disorder was first reported in 1990 by Teunissen and Cremers. Since then, various phenotypic presentations of NOG mutation have been reported, leading to the introduction of the term NOG-related symphalangism spectrum disorder (NOG-SSD). Case report: In this report, we describe a family (mother and daughter) with bilateral mixed hearing loss. Both patients had hyperopia, distinct facial appearance with hemicylindrical nose, broad thumbs, and syndactyly of the second and third toes. Genetic testing confirmed a NOG gene mutation. Bilateral stapedotomy was successfully performed, resulting in significant hearing improvement. However, due to sensorineural component of hearing loss, complete hearing recovery was only achieved with the use of hearing aids. Discussion: The etiology of the sensorineural component of hearing loss in NOG-SSD remains unclear. In animal models, the NOG gene is essential for inner ear development, while in humans, only middle ear malformations have been reported. The phenotypic variability observed in individuals with NOG mutations is very wide, suggesting that the sensorineural component of hearing loss could represent one of the possible manifestations. Conclusions: Conductive hearing loss is the primary manifestation of the NOG-SSD, and all previously reported cases of NOG gene mutations have presented exclusively with conductive hearing loss. It is possible that additional genetic factors, not necessarily directly related to the NOG gene but present in this family, contribute to the development of the sensorineural component of hearing loss, although thorough genetic testing did not reveal any additional mutation. This is, to our knowledge, the first report of mixed hearing loss associated with a NOG mutation confirmed preoperatively. Further studies are needed to determine whether the sensorineural component represents a primary manifestation or arises from secondary mechanisms.

Background/objectives: Previous research has demonstrated that the perception of self-motion, as signaled by cervical proprioception, is significantly altered during neck muscle fatigue, while no similar effects are observed when self-motion is signaled by the vestibular system. Given that in typical natural movements, both proprioceptive and vestibular signals are activated simultaneously, this study sought to investigate whether the misperception of motion persists during neck muscle fatigue when both proprioceptive and vestibular stimulation are present.

Methods: The study evaluated the gain of the perceptual responses to symmetric yaw sinusoidal head rotations on a stationary trunk during visual target localization tasks across different rotational frequencies. In addition, the final localization error of the visual target was assessed following asymmetric sinusoidal head rotations with differing half-cycle velocities.

Results: The findings indicated that even with combined proprioceptive and vestibular stimulation, self-motion perceptual responses under neck muscle fatigue showed a pronounced reduction in the gain at low-frequency stimuli and a notable increase in localization error following asymmetric rotations. Notably, spatial localization error was observed to persist after asymmetric stimulation conditioning in the light. Additionally, even moderate levels of muscle fatigue were found to result in increased self-motion misperception.

Conclusions: This study suggests that neck muscle fatigue can disrupt spatial orientation, even when the vestibular system is activated, so that slow movements are inaccurately perceived. This highlights the potential risks associated with neck muscle fatigue in daily activities that demand precise spatial perception.