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An Evaluation of the Psychometric Properties of the Short Form of the Speech, Spatial and Qualities of Hearing Scale in Swedish: Online Versus Paper-and-Pen. 瑞典语言语、空间和听力质量量表简表心理测量特性评估:在线问卷与纸笔问卷的对比
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-30 DOI: 10.1044/2024_AJA-24-00131
Sandra Ahlberg, Jonas Brännström, Marie Öberg, Elisabet Thorén

Purpose: The purpose of this study was to examine the psychometric properties of the Swedish short form of the Speech, Spatial and Qualities of Hearing Scale (SSQ12) and investigate whether the paper-and-pen and online formats could be used interchangeably.

Method: Individuals with and without hearing problems were invited to participate in this study. The participants (N = 125) were randomized into four groups: paper-paper, online-online, paper-online, and online-paper. All participants completed the Swedish SSQ12 twice.

Results: Principal components analysis revealed one component. Statistical analysis revealed good psychometric properties. Administration formats were compared using repeated-measures analysis of variance, which revealed no statistically significant differences.

Conclusions: The results indicate that the Swedish SSQ12 is possible to use in paper-and-pen and online formats interchangeably. The questionnaire has potential to be used by Swedish audiologists seeking to understand the individual experience of hearing loss or to evaluate hearing rehabilitation. To further understand the possible differences and to broaden the use and understanding of the SSQ12, future studies should aim to determine the minimal clinically important difference for the SSQ12.

目的:本研究的目的是检验瑞典语、空间和听力素质量表(SSQ12)简表的心理测量特性,并调查纸笔格式和在线格式是否可以互换使用:方法:本研究邀请有听力问题和没有听力问题的人参加。参与者(N = 125)被随机分为四组:纸质-纸质组、在线-在线组、纸质-在线组和在线-纸质组。所有参与者都完成了两次瑞典 SSQ12:结果:主成分分析显示有一个成分。统计分析显示该问卷具有良好的心理测量特性。使用重复测量方差分析对管理形式进行了比较,结果显示在统计上没有显著差异:结果表明,瑞典 SSQ12 可以在纸笔和在线两种形式中交替使用。瑞典听力学家在了解听力损失的个人经历或评估听力康复时,有可能使用该问卷。为了进一步了解可能存在的差异并扩大 SSQ12 的使用范围和理解范围,未来的研究应旨在确定 SSQ12 的最小临床重要差异。
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引用次数: 0
Understanding Tinnitus Clinical Care in the Veterans Health Administration and Department of Defense: Overview of Survey Results. 了解退伍军人健康管理局和国防部的耳鸣临床护理:调查结果概述。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-22 DOI: 10.1044/2024_AJA-24-00060
Amy Boudin-George, Erin Cesario, Catherine Edmonds, Emily J Thielman, James A Henry, Khaya Clark

Purpose: In 2021, the Veterans Health Administration (VHA) and Department of Defense (DOD) Tinnitus Working Group conducted a survey of DOD and VHA clinicians to evaluate clinical services provided for tinnitus.

Method: The online survey included a mix of multiple-choice and open-ended questions. Respondents included VHA and DOD health care providers in audiology, otolaryngology, mental health, and primary care, as well as DOD hearing conservation technicians. Quantitative and qualitative methods were used to analyze the data.

Results: A total of 669 providers responded to this combined survey. Results indicated that compared to DOD and VHA providers in other fields, audiologists tended to be more confident and more aware of their role in tinnitus management. In terms of confidence and scope of practice, DOD mental health care providers were the group least familiar with tinnitus care. Other results explored herein include barriers to tinnitus care, facilitators for progressive tinnitus management programs, interventions and patient materials offered, new patient materials wanted, and respondents' preferred information sources and training methods.

Conclusion: Survey results indicated that more directed education and support are needed to increase DOD and VHA clinicians' awareness of the need for tinnitus services and their roles in providing that care.

Supplemental material: https://doi.org/10.23641/asha.27229215.

目的:2021 年,退伍军人健康管理局(VHA)和国防部(DOD)耳鸣工作组对国防部和退伍军人健康管理局的临床医生进行了一项调查,以评估为耳鸣提供的临床服务:在线调查包括多项选择题和开放式问题。受访者包括退伍军人事务部和国防部的听力、耳鼻喉科、心理健康和初级保健医疗服务提供者,以及国防部听力保护技术人员。采用定量和定性方法对数据进行分析:共有 669 名医疗服务提供者参与了此次联合调查。结果表明,与国防部和退伍军人事务部其他领域的医疗服务提供者相比,听力学家往往更有信心,也更了解自己在耳鸣管理中的作用。就信心和执业范围而言,国防部精神卫生保健提供者是最不熟悉耳鸣治疗的群体。本文探讨的其他结果包括耳鸣护理的障碍、渐进式耳鸣管理计划的促进因素、提供的干预措施和患者资料、新患者需要的资料以及受访者首选的信息来源和培训方法:调查结果表明,需要更多有针对性的教育和支持,以提高国防部和退伍军人事务部临床医生对耳鸣服务需求及其在提供耳鸣护理中的作用的认识。补充材料:https://doi.org/10.23641/asha.27229215。
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引用次数: 0
Incidence of Self-Reported Bothersome Tinnitus Versus Tinnitus Diagnosis Among U.S. Army Soldiers. 美国陆军士兵自述困扰性耳鸣与耳鸣诊断的发生率。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-22 DOI: 10.1044/2024_AJA-24-00053
LaGuinn P Sherlock, Kelly J Gibson, Daniel S Talian, Deborah C Lake

Purpose: U.S. Army Soldiers undergo annual audiometric surveillance to facilitate prevention of auditory injury. Soldiers are screened for bothersome tinnitus and subsequently referred for a clinical audiological evaluation as warranted. Presumably, most Soldiers seen in the clinic for bothersome tinnitus receive a tinnitus diagnosis. The incidence of self-reported bothersome tinnitus at the time of annual audiometric surveillance and subsequent diagnosis of tinnitus in the medical record has not been examined to date. This study estimated the incidence of tinnitus diagnosis in a population of Soldiers who reported new onset bothersome tinnitus and explored trends associated with tinnitus diagnosis to refine hearing health education.

Method: A subset of hearing conservation records retrieved for a previous study were selected based on change in self-reporting of bothersome tinnitus. Corresponding medical records were retrieved for this sample of Active Duty (AD) Soldiers. The data were retrospectively examined, and analyses were conducted to identify statistically significant differences between Soldiers with and Soldiers without a tinnitus diagnosis. In addition, trend patterns of bothersome tinnitus and significant threshold shift (STS) were examined.

Results: Of the sample of 730,350 AD Soldiers, 16.7% self-reported new onset bothersome tinnitus and 7.1% of those recorded as having bothersome tinnitus had a diagnosis of tinnitus in their medical record. Soldiers with a tinnitus diagnosis were older and had higher pure-tone averages than Soldiers without a tinnitus diagnosis. Counterintuitively, overall trend percentages of bothersome tinnitus increased per calendar year, while the percentages of STS decreased throughout the study period.

Conclusions: The rate of tinnitus diagnosis in the medical record is vastly lower than the prevalence of bothersome tinnitus recorded in the annual surveillance system. Steps should be taken to screen, refer, and diagnose tinnitus more consistently. Based on the outcome of the study analysis, we recommend that screening for bothersome tinnitus more closely follows procedure recommendations from the Department of Veterans Affairs and Department of Defense (VA/DOD) Tinnitus Working Group, which may reduce the rate at which Soldiers report bothersome tinnitus.

目的:美国陆军士兵每年都要接受听力监测,以预防听力损伤。对士兵进行耳鸣筛查,然后根据需要转诊进行临床听力评估。据推测,大多数因耳鸣困扰而就诊的士兵都会得到耳鸣诊断。迄今为止,尚未对年度听力监测时自我报告的困扰性耳鸣的发生率以及随后在医疗记录中的耳鸣诊断进行过研究。本研究估算了报告新发困扰性耳鸣的士兵中耳鸣诊断的发生率,并探讨了与耳鸣诊断相关的趋势,以完善听力健康教育:方法:根据自我报告的耳鸣症状的变化情况,选择为之前的一项研究检索的听力保护记录子集。我们还检索了现役(AD)士兵样本的相应医疗记录。对这些数据进行了回顾性检查,并进行了分析,以确定有耳鸣诊断的士兵与没有耳鸣诊断的士兵之间在统计学上的显著差异。此外,还研究了令人烦恼的耳鸣和显著阈值偏移(STS)的趋势模式:在 730,350 名退伍士兵样本中,16.7% 的士兵自述有新发的耳鸣困扰,7.1% 记录有耳鸣困扰的士兵在医疗记录中被诊断为耳鸣。与未确诊耳鸣的士兵相比,确诊耳鸣的士兵年龄更大,纯音平均值更高。与直觉相反的是,在整个研究期间,令人烦恼的耳鸣的总体百分比呈逐年上升趋势,而STS的百分比则呈逐年下降趋势:结论:医疗记录中的耳鸣诊断率远远低于年度监测系统中记录的困扰性耳鸣患病率。应采取步骤对耳鸣进行更一致的筛查、转诊和诊断。根据研究分析的结果,我们建议在筛查困扰性耳鸣时更多地遵循退伍军人事务部和国防部(VA/DOD)耳鸣工作组的程序建议,这可能会降低士兵报告困扰性耳鸣的比率。
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引用次数: 0
Effect of Level and Frequency of Forward Masker on Auditory Brainstem Response. 前向掩蔽器的电平和频率对听觉脑干反应的影响
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-17 DOI: 10.1044/2024_AJA-24-00021
Durga S Kumar, Sreeraj Konadath

Purpose: Forward masking (FM) is characterized by the perception of a signal being reduced or wholly masked due to a preceding sound (masker) of the same or different frequencies that offers a challenge for the auditory system to resolve. Considering that the off-frequency masker is expected to undergo linear processing compared to the on-frequency masker at the signal place, it reflects the peripheral auditory systems' compressive response. Thus, the present study focused on employing FM electrophysiological analogous such as auditory brainstem responses (ABR) to the behavioral masking experiments to objectively measure the frequency and level of processing in the auditory system, from the periphery to the brainstem level.

Method: The study was an observational research on 21 female volunteers. ABR was obtained using a tone-on-tone FM paradigm for 1000- and 4000-Hz probe stimuli. An experiment used two forward maskers, on-frequency and off-frequency, with varying levels from 50 to 70 dB SPL.

Results: A progressive shift for Vth peak latency and reduction in response amplitude was observed in proportion to the increase of masker level for both the probe stimuli and the masking experiments. However, ABR responses in neither masking condition were observed to differ between 60 and 70 dB SPL.

Conclusion: FM ABR experiments are an assessment tool for estimating frequency and level processing in the auditory system, providing good efficiency, reliability, and less subject bias compared to behavioral measures.

目的:前向掩蔽(FM)的特点是,由于前一个相同或不同频率的声音(掩蔽器)给听觉系统带来了解决难题的挑战,从而导致信号被减弱或完全掩蔽。考虑到非频率掩蔽器与信号处的正频率掩蔽器相比,预计会进行线性处理,它反映了外周听觉系统的压缩反应。因此,本研究侧重于在行为掩蔽实验中使用调频电生理类似物,如听觉脑干反应(ABR),以客观测量听觉系统从外围到脑干水平的处理频率和水平:本研究是一项观察性研究,对象是 21 名女性志愿者。ABR是在1000和4000赫兹的探头刺激下,通过音调对音调调频范式获得的。实验中使用了两个前向掩蔽器,分别是频率上和频率下的掩蔽器,掩蔽器的声压级从 50 到 70 dB SPL 不等:结果:在探究刺激和掩蔽实验中,都观察到 Vth 峰值延迟的逐渐移动和反应幅度的减小与掩蔽器水平的增加成正比。然而,在 60 和 70 dB SPL 之间,两种掩蔽条件下的 ABR 反应均未观察到差异:调频 ABR 实验是评估听觉系统中频率和电平处理的一种评估工具,与行为测量相比,具有效率高、可靠性强、受试者偏差小等优点。
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引用次数: 0
Relationship Between Socioeconomic Status and Basic Auditory Processing in Young Adults. 社会经济地位与青少年基本听觉处理能力之间的关系。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-17 DOI: 10.1044/2024_AJA-24-00147
Bhamini Sharma, Akshay R Maggu

Purpose: The current study aimed at investigating the relationship between socioeconomic status (SES) and basic auditory processing in young adults with normal hearing. Specifically, we sought to determine whether SES metrics, including parental education, parental occupation, and individual education attainment, influenced performance on tasks of basic auditory processing. Secondarily, we also aimed at understanding the interactive effects of SES and working memory on basic auditory processing.

Method: A total of 38 young adults were included in the study. Self-reported SES measures were recorded through Likert scales, and auditory processing measures included tests for temporal fine structure (TFS) and spectrotemporal sensitivity (STS). Pearson correlation analyses were conducted to probe the relationships between SES indicators and auditory processing performance. Multiple linear regressions were conducted to understand the interactive effects of SES and working memory on auditory processing performance.

Results: The analysis revealed no significant correlation between SES measures and basic auditory processing performance across TFS and STS tasks. Furthermore, analysis investigating the interaction between SES and working memory also yielded nonsignificant results. These findings indicate that, within this specific age cohort, SES information may not be indispensable for assessing basic auditory processing.

Conclusions: Our study suggests that SES may not significantly influence basic auditory processing in young adults with normal hearing. However, further research with larger sample sizes and longitudinal designs is warranted to confirm these findings and explore potential age-related differences in the impact of SES on auditory processing across the lifespan.

目的:本研究旨在调查听力正常的年轻成年人的社会经济地位(SES)与基本听觉处理之间的关系。具体来说,我们试图确定社会经济地位指标(包括父母教育程度、父母职业和个人教育程度)是否会影响基本听觉处理任务的表现。其次,我们还希望了解社会经济条件和工作记忆对基本听觉处理能力的交互影响:方法:本研究共纳入 38 名青少年。通过李克特量表记录自我报告的 SES 测量,听觉处理测量包括时间精细结构(TFS)和谱时敏感性(STS)测试。为了探究 SES 指标与听觉处理能力之间的关系,我们进行了皮尔逊相关分析。为了了解 SES 和工作记忆对听觉处理能力的交互影响,还进行了多元线性回归:分析表明,在 TFS 和 STS 任务中,SES 指标与基本听觉处理成绩之间没有明显的相关性。此外,对 SES 和工作记忆之间交互作用的分析结果也不显著。这些研究结果表明,在这个特定的年龄组中,SES 信息对于评估基本听觉处理能力可能并不是不可或缺的:我们的研究表明,社会经济地位可能不会对听力正常的年轻人的基本听觉处理能力产生重大影响。然而,为了证实这些研究结果,并探索社会经济地位对听觉处理的影响在整个生命周期中可能存在的年龄相关差异,我们有必要利用更大的样本量和纵向设计开展进一步研究。
{"title":"Relationship Between Socioeconomic Status and Basic Auditory Processing in Young Adults.","authors":"Bhamini Sharma, Akshay R Maggu","doi":"10.1044/2024_AJA-24-00147","DOIUrl":"https://doi.org/10.1044/2024_AJA-24-00147","url":null,"abstract":"<p><strong>Purpose: </strong>The current study aimed at investigating the relationship between socioeconomic status (SES) and basic auditory processing in young adults with normal hearing. Specifically, we sought to determine whether SES metrics, including parental education, parental occupation, and individual education attainment, influenced performance on tasks of basic auditory processing. Secondarily, we also aimed at understanding the interactive effects of SES and working memory on basic auditory processing.</p><p><strong>Method: </strong>A total of 38 young adults were included in the study. Self-reported SES measures were recorded through Likert scales, and auditory processing measures included tests for temporal fine structure (TFS) and spectrotemporal sensitivity (STS). Pearson correlation analyses were conducted to probe the relationships between SES indicators and auditory processing performance. Multiple linear regressions were conducted to understand the interactive effects of SES and working memory on auditory processing performance.</p><p><strong>Results: </strong>The analysis revealed no significant correlation between SES measures and basic auditory processing performance across TFS and STS tasks. Furthermore, analysis investigating the interaction between SES and working memory also yielded nonsignificant results. These findings indicate that, within this specific age cohort, SES information may not be indispensable for assessing basic auditory processing.</p><p><strong>Conclusions: </strong>Our study suggests that SES may not significantly influence basic auditory processing in young adults with normal hearing. However, further research with larger sample sizes and longitudinal designs is warranted to confirm these findings and explore potential age-related differences in the impact of SES on auditory processing across the lifespan.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Sacculocollic and Vestibulomasseteric Reflex Pathways in Individuals With Migraine and Vestibular Migraine. 评估偏头痛和前庭性偏头痛患者的骶结膜和前庭肌肉反射通路。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-16 DOI: 10.1044/2024_AJA-24-00107
Adithya Sreedharan Sanitha, Sujeet Kumar Sinha

Purpose: The study's objective was to evaluate the functioning of sacculocollic and vestibulomasseteric reflex pathways in individuals with vestibular migraine and migraine.

Method: Seventy-five participants aged 18-50 years were selected for the study. Participants were divided into three groups. Group 1 consisted of 25 healthy individuals, Group 2 consisted of 25 migraine individuals, and Group 3 consisted of 25 individuals with vestibular migraine. Cervical vestibular-evoked myogenic potential (cVEMP) and masseter vestibular-evoked myogenic potential (mVEMP) were recorded using a 500-Hz tone burst stimulus presented at 125 dB peSPL for all participants.

Results: The cVEMP test results showed a delayed p13 and n23 latency for both migraine and vestibular migraine individuals when compared to healthy individuals. Also, the amplitude of the p13-n23 peak was reduced compared to healthy individuals in both migraine and vestibular migraine. Similarly, the mVEMP test results showed a delayed p11 and n21 latency for both migraine and vestibular migraine individuals. No difference was observed in the amplitude of the p11-n21 peak complex between the three groups. Spearman's rho correlation revealed no significant (p > .05) correlation between cervical and masseter VEMP latency and amplitude parameters between healthy, migraine, and vestibular migraine individuals.

Conclusions: The results of the study are suggestive of the pathology of the sacullocollic and vestibulomasseteric reflex pathways in individuals with migraine and vestibular migraine. Individuals with migraine and vestibular migraine should undergo a detailed vestibular evaluation.

目的:本研究旨在评估前庭性偏头痛和偏头痛患者的骶结膜反射通路和前庭肌肉反射通路的功能:研究选择了 75 名 18-50 岁的参与者。参与者分为三组。第一组由 25 名健康人组成,第二组由 25 名偏头痛患者组成,第三组由 25 名前庭性偏头痛患者组成。所有参与者均使用 125 dB peSPL 的 500 赫兹音爆刺激记录颈前庭诱发肌源性电位(cVEMP)和颌前庭诱发肌源性电位(mVEMP):结果:cVEMP测试结果显示,与健康人相比,偏头痛和前庭性偏头痛患者的p13和n23潜伏期均有所延迟。此外,偏头痛和前庭性偏头痛患者的p13-n23峰值振幅与健康人相比都有所降低。同样,mVEMP测试结果显示,偏头痛和前庭性偏头痛患者的p11和n21潜伏期都有所延迟。三组患者的 p11-n21 峰复合振幅没有差异。Spearman's rho 相关性表明,健康人、偏头痛患者和前庭性偏头痛患者的颈部和颌间肌 VEMP 潜伏期和振幅参数之间没有明显的相关性(p > .05):研究结果表明,偏头痛和前庭性偏头痛患者的骶尾结缔组织和前庭肌肉反射通路存在病变。偏头痛和前庭性偏头痛患者应接受详细的前庭评估。
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引用次数: 0
Simulation-Based Approaches for Training Communication and Counseling Skills in Clinical Education in Audiology: A Scoping Review. 在听力学临床教育中训练沟通和咨询技能的模拟方法:范围综述。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-16 DOI: 10.1044/2024_AJA-24-00097
Amisha Kanji, Jennifer Watermeyer

Purpose: This review article aimed to obtain an understanding of the positive outcomes and challenges associated with the use of simulation-based approaches for teaching communication and counseling skills in clinical education in audiology as described in the literature.

Method: A scoping review was conducted during October 2023 to identify published journal articles that described how simulation-based approaches were used for teaching or assessing communication and/or counseling skills among audiology students. Database searches yielded 208 articles initially. Following abstract screening and full-text review, 17 articles were included for analysis.

Results: Most studies focused on using simulation-based approaches for teaching, and there was a stronger focus on pediatric audiology. Most studies involved the use of standardized patients, with data collected via quantitative approaches using rating scales and surveys. Simulation-based approaches can offer positive learning experiences and practice opportunities for students acquiring communication and counseling skills. However, the benefits of simulation over traditional methods are unclear. Students may struggle to integrate technical and communication skills in simulated learning experiences.

Conclusions: Engaging with simulation-based approaches may provide important practice opportunities, but these methods are not sufficient to ensure acquisition of communication and counseling skills. More qualitative studies are needed to understand the nuances of if and how students might acquire such skills via simulated learning experiences. We offer some suggestions for improvement of future studies on this topic.

目的:这篇综述文章旨在了解文献中描述的在听力学临床教育中使用基于模拟的方法教授沟通和咨询技能的积极成果和相关挑战:在 2023 年 10 月期间进行了一次范围界定审查,以确定已发表的期刊文章,这些文章描述了如何在听力学学生中使用基于模拟的方法来教学或评估沟通和/或咨询技能。通过数据库搜索,最初获得了 208 篇文章。经过摘要筛选和全文审阅,共纳入 17 篇文章进行分析:结果:大多数研究侧重于使用模拟教学法进行教学,而且更侧重于儿科听力学。大多数研究涉及使用标准化患者,并通过评分量表和调查等定量方法收集数据。模拟教学法可为学生提供积极的学习体验和实践机会,帮助他们掌握沟通和咨询技能。然而,与传统方法相比,模拟方法的优势尚不明确。学生可能很难在模拟学习体验中将技术和沟通技能融为一体:结论:参与基于模拟的方法可以提供重要的实践机会,但这些方法不足以确保获得沟通和咨询技能。我们需要进行更多的定性研究,以了解学生是否以及如何通过模拟学习体验获得这些技能的细微差别。我们对今后有关这一主题的研究提出了一些改进建议。
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引用次数: 0
A Comparison of 226- and 1000-Hz Probe Tone Tympanometry With Myringotomy Findings in Infants. 婴儿 226 赫兹和 1000 赫兹探针音鼓测量法与耳轮切开术结果的比较。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-16 DOI: 10.1044/2024_AJA-24-00062
Donata Gellrich, Katharina Eder, Matthias Echternach, Moritz Gröger, Patrick Huber

Purpose: This study aimed to verify the diagnostic value of tympanometry with 226- and 1000-Hz probe tones in infants by comparing tympanometry results with the gold standard of the middle ear state assessed by myringotomy. Furthermore, clinically useful predictors for false peaked tympanograms despite the presence of middle ear fluid should be identified.

Method: Pre-operative 226- and 1000-Hz tympanograms were retrospectively compared with intraoperative findings of the tympanic cavity after myringotomy in 111 infants (217 ears) aged ≤ 12 months. In addition to the shape of tympanograms, demographic and clinical characteristics, the results of other audiometric measurements, and the viscosity of middle ear fluid, if present, were evaluated in several subgroups.

Results: The sensitivity and specificity of 1000-Hz tympanometry for middle ear effusion (MEE) detection were 97%-98% and 71%-84%, respectively, whereas standard tympanometry with a 226-Hz probe tone achieved a poor sensitivity of 43%-61% and a specificity of 81%-97%. Younger age, low viscosity of the middle ear fluid, and female sex were associated with an increased risk of false peaked 226-Hz tympanograms despite MEE. Furthermore, larger equivalent outer ear canal volumes were linked to false peaked 226-Hz tympanograms.

Conclusions: The comparison of myringotomy findings and 226- and 1000-Hz tympanometry confirms the superiority of high-frequency tympanometry in infants younger than 12 months. Although this study identified some vague predictors of potentially false peaked 226-Hz tympanograms, the assessment of the middle ear state by 226-Hz tympanometry remains unreliable in young infants.

目的:本研究旨在通过将鼓室测量结果与通过耳轮切开术评估中耳状态的金标准进行比较,验证使用 226 赫兹和 1000 赫兹探头音对婴儿进行鼓室测量的诊断价值。此外,还应找出在中耳积液存在的情况下出现假峰值鼓室图的临床有用预测因素:方法:对 111 名年龄小于 12 个月的婴儿(217 耳)进行了耳膜切开术,并将术前 226Hz 和 1000Hz 鼓室图与术后鼓室检查结果进行了回顾性比较。除了鼓室图的形状外,还对几个分组的人口统计学和临床特征、其他听力测量结果以及中耳积液(如果存在)的粘度进行了评估:结果:1000 赫兹鼓室压测量法检测中耳积液(MEE)的灵敏度和特异度分别为 97%-98% 和 71%-84% ,而使用 226 赫兹探头音的标准鼓室压测量法的灵敏度和特异度分别为 43%-61% 和 81%-97% 。年龄越小、中耳液粘度越低和女性性别与尽管有 MEE 但出现 226-Hz 假峰值鼓室图的风险增加有关。此外,等效外耳道容积越大,226Hz鼓室图出现假峰值的风险越高:结论:对耳廓切开术结果与226 Hz和1000 Hz鼓室测压法的比较证实了高频鼓室测压法在12个月以下婴儿中的优越性。尽管该研究发现了一些可能导致226 Hz鼓室造影出现假峰值的模糊预测因素,但通过226 Hz鼓室测量法评估幼婴的中耳状态仍然不可靠。
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引用次数: 0
Vestibular and Balance Considerations in Type 2 Diabetes: A Tutorial on Pertinent Areas and Issues. 2 型糖尿病的前庭和平衡考虑因素:相关领域和问题教程。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-14 DOI: 10.1044/2024_AJA-24-00075
Zakaria Enayati, Anthony T Cacace

Purpose: The purpose of this study is to describe the effects of diabetes mellitus (DM) on vestibular and balance system functions in humans. Because Type 2 diabetes (T2D) represents the majority of individuals affected by this condition, this subgroup is the main focus of this tutorial.

Method: Evidence of dysfunction is based on epidemiological, anatomical, physiological, neuroimaging, and clinical findings. Preventative measures, therapeutic interventions, and other mitigating factors are also given consideration.

Results: Experimental and clinical findings support the notion that T2D damages vestibular and balance systems to the extent that these effects are more prevalent in patients with higher blood glucose levels and longer duration of the disease. Evidence indicates that T2D increases the occurrence and re-occurrence rates of benign paroxysmal positional vertigo, particularly when it occurs in conjunction with hypertension, osteoarthritis, and otologic disorders like Ménière's disease. Type 2 diabetes also impairs vestibular compensation, which is exacerbated by disease duration. Investigational and clinical studies suggest that galvanic stimulation of the vestibular system can be effective in reducing blood glucose levels and improving rehabilitation outcomes.

Conclusion: Because DM is a chronic metabolic condition affecting cochlear, vestibular, and balance system functions, lowering blood glucose levels through diet, pharmacological interventions, and exercise can be effective in mitigating dysfunction.

目的:本研究旨在描述糖尿病(DM)对人体前庭和平衡系统功能的影响。由于 2 型糖尿病(T2D)患者占糖尿病患者的大多数,因此该亚群是本教程的重点:方法:功能障碍的证据基于流行病学、解剖学、生理学、神经影像学和临床发现。此外,还考虑了预防措施、治疗干预和其他缓解因素:实验和临床研究结果支持以下观点:T2D 会损害前庭和平衡系统,血糖水平越高、病程越长的患者受到的影响越普遍。有证据表明,2 型糖尿病会增加良性阵发性位置性眩晕的发生率和复发率,尤其是当它与高血压、骨关节炎和梅尼埃病等耳科疾病同时发生时。2 型糖尿病也会损害前庭代偿功能,而病程的延长又会加剧这种损害。调查和临床研究表明,对前庭系统进行电刺激可有效降低血糖水平,改善康复效果:结论:由于 DM 是一种影响耳蜗、前庭和平衡系统功能的慢性代谢性疾病,通过饮食、药物干预和运动降低血糖水平可有效缓解功能障碍。
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引用次数: 0
Evidence of Peripheral Vestibular Impairment Among Adults With Chronic Moderate-Severe Traumatic Brain Injury. 慢性中重度创伤性脑损伤成人外周前庭功能障碍的证据。
IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-10-11 DOI: 10.1044/2024_AJA-24-00058
Jessica J Feller, Melissa C Duff, Sharice Clough, Gary P Jacobson, Richard A Roberts, Daniel J Romero

Purpose: Traumatic brain injury (TBI) is a leading cause of death and disability among adults in the United States. There is evidence to suggest the peripheral vestibular system is vulnerable to damage in individuals with TBI. However, there are limited prospective studies that describe the type and frequency of vestibular impairment in individuals with chronic moderate-severe TBI (> 6 months postinjury).

Method: Cervical and ocular vestibular evoked myogenic potentials (VEMPs) and video head impulse test (vHIT) were used to assess the function of otolith organ and horizontal semicircular canal (hSCC) pathways in adults with chronic moderate-severe TBI and in noninjured comparison (NC) participants. Self-report questionnaires were administered to participants with TBI to determine prevalence of vestibular symptoms and quality of life associated with those symptoms.

Results: Chronic moderate-severe TBI was associated with a greater degree of impairment in otolith organ, rather than hSCC, pathways. About 63% of participants with TBI had abnormal VEMP responses, compared to only ~10% with abnormal vHIT responses. The NC group had significantly less abnormal VEMP responses (~7%), while none of the NC participants had abnormal vHIT responses. As many as 80% of participants with TBI reported vestibular symptoms, and up to 36% reported that these symptoms negatively affected their quality of life.

Conclusions: Adults with TBI reported vestibular symptoms and decreased quality of life related to those symptoms and had objective evidence of peripheral vestibular impairment. Vestibular testing for adults with chronic TBI who report persistent dizziness and imbalance may serve as a guide for treatment and rehabilitation in these individuals.

目的:创伤性脑损伤(TBI)是导致美国成年人死亡和残疾的主要原因。有证据表明,创伤性脑损伤患者的外周前庭系统很容易受到损伤。然而,描述慢性中度-重度 TBI 患者(伤后 6 个月以上)前庭受损类型和频率的前瞻性研究却很有限:方法:使用颈部和眼部前庭诱发肌源性电位(VEMPs)和视频头脉冲测试(vHIT)来评估慢性中度严重创伤性脑损伤成人患者和未受伤的对比(NC)参与者的耳石器官和水平半规管(hSCC)通路的功能。对患有创伤性脑损伤的参与者进行了自我报告问卷调查,以确定前庭症状的发生率以及与这些症状相关的生活质量:结果:慢性中重度创伤性脑损伤与耳石器官而非前庭神经丛通路的损伤程度有关。约 63% 的创伤性脑损伤患者有异常 VEMP 反应,而只有约 10% 的患者有异常 vHIT 反应。NC 组的 VEMP 反应异常率明显较低(约为 7%),而 NC 参与者中没有人出现 vHIT 反应异常。多达 80% 的创伤性脑损伤患者报告了前庭症状,高达 36% 的患者表示这些症状对他们的生活质量产生了负面影响:结论:患有创伤性脑损伤的成年人都有前庭症状,并且生活质量下降与这些症状有关,而且有外周前庭受损的客观证据。对报告有持续头晕和失衡症状的慢性创伤性脑损伤成人进行前庭测试,可为这些人的治疗和康复提供指导。
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引用次数: 0
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American Journal of Audiology
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