American Journal of Audiology最新文献

Purpose: This systematic review aims to evaluate the efficacy of single-session interventions of tinnitus educational counseling (SSI-TEDs) in the management of tinnitus.

Method: A systematic literature search was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five studies met the inclusion criteria: three were two-arm randomized controlled trials (RCTs), and two employed a pretest-posttest design. Two studies compared SSI-TED with other interventions-neuro-music therapy (n = 1) and hypnosis (n = 1). One study included a homework component for 50% of the participants, and another combined SSI-TED with mindfulness and relaxation training.

Results: Across five studies, a total of 307 participants received SSI-TED, while 190 were given alternative interventions. At 1-3 months follow-up, one RCT demonstrated a small-to-medium effect of SSI-TED on reducing tinnitus severity and distress. Pretest-posttest studies reported large effects of SSI-TED on these outcomes. Improvements were also observed in negative emotions, frustration, rumination, and social life. The long-term effect of SSI-TED was noted in one study. No significant effects were found for anxiety or depression.

Conclusions: SSI-TED appears to be a promising intervention for reducing tinnitus-related distress and improving emotional well-being in the short term. The evidence suggests moderate benefits in control conditions and larger effects when evaluated in uncontrolled settings. However, its impact on comorbid anxiety and depression remains unclear. Further high-quality studies with long-term follow-up are needed to establish the sustained efficacy, effectiveness, and broader psychological benefits of SSI-TED.

Supplemental material: https://doi.org/10.23641/asha.31215364.

Purpose: Idiopathic sudden sensorineural hearing loss (SSNHL) is an otologic emergency with often unclear etiology. Vestibular migraine (VM) is a neurological disorder that may coexist with auditory symptoms and potentially affect hearing outcomes. The purpose of this study was to determine the prevalence of VM in patients with idiopathic SSNHL and assess its impact on hearing recovery after treatment.

Method: Forty-three patients aged 20-71 years with idiopathic SSNHL were included. All underwent audiological evaluation and were assessed for VM using the Bárány Society criteria. Hearing recovery was evaluated based on Siegel criteria. Clinical features and hearing outcomes were compared between the VM and non-VM groups.

Results: VM was diagnosed in 10 (23.3%) patients and migraine in 14 (32.6%). The mean age was 52.5 ± 14.0 years in the VM group and 44.7 ± 14.6 in the non-VM group. No significant differences were found between groups in age, gender, comorbidities, or baseline/posttreatment hearing thresholds (p > .05). Treatment response was also similar (p = .197).

Conclusions: VM is relatively frequent in patients with idiopathic SSNHL, but does not significantly influence hearing severity or recovery. Further studies with larger samples are needed to clarify the relationship between VM and SSNHL.

Purpose: Reduced spectral resolution limits speech recognition in cochlear implant (CI) listeners. Although many studies have examined this association, uncertainties remain regarding its strength and contributing methodological and clinical factors. This narrative review synthesizes findings from studies of postlingually deafened adult CI listeners, focusing on psychophysical measures of spectral resolution and their strengths and limitations.

Method: We reviewed studies published through January 2025 that examined the relationship between psychophysical measures of spectral resolution and speech perception outcomes in postlingually deafened adult CI listeners. Twenty-four studies met inclusion criteria and tested this association statistically. Where available, the coefficient of determination (R²) and effect size measures were extracted to quantify the strength of this association.

Results: Several studies found a statistically significant association between psychophysical measures of spectral resolution and speech recognition performance. The predictive power of spectral resolution measures for speech perception outcomes varied substantially (R² = .21-.69), depending on the specific measure used and the type of speech material. Spectral ripple discrimination/detection threshold tasks and their modified versions, on average, show higher predictive capacity for investigating this link. These measures are especially predictive when using speech materials such as consonant-nucleus-consonant words and AzBio or Institute of Electrical and Electronics Engineering sentences presented in quiet or multitalker babble at moderate signal-to-noise ratios. In contrast, measures based on forward-masking paradigms and pitch ranking tend to yield weaker or nonsignificant associations.

Conclusions: The review underscores spectral resolution as a key leverage point in efforts to improve speech recognition outcomes. Variability in observed associations highlights the need for further mechanistic research into the pathways linking spectral resolution to speech recognition outcomes. Future studies are warranted to improve both the predictive accuracy and clinical feasibility of spectral resolution assessment tools.

Introduction: Effective clinical education is foundational to developing competent audiologists, yet limited research has explored which specific clinical teaching approaches students perceive as most effective. Much of the existing evidence is drawn from researcher and clinical educator perspectives, rather than student perspectives of effective clinical education approaches.

Objective: The purpose of this qualitative research project was to identify themes from clinical teaching strategies that doctor of audiology (AuD) students perceive as most effective during clinical placements with community clinical instructors.

Method: Using Braun and Clarke's six-step reflexive thematic analysis framework, open-ended survey responses from 62 AuD students at the University of Pittsburgh were analyzed. Data reflected responses to the question "What teaching strategy(s) used by your clinical instructor most positively impacted your learning this term?" These data were coded and subsequently grouped into themes.

Results: Five themes were identified: engaging student thought, independence, productive feedback, supportive approach, and teaching strategies. Many responses revealed overlapping codes across themes, indicating the interconnected nature of effective clinical instruction practices.

Conclusions: The most reported effective strategy included a clear pathway to independent learning. Students commonly noted the value of productive feedback and questioning techniques to engage their thinking. The clinical instructor's openness and support were highly valued, as was intentional explanation and modeling of clinical skills. The components of effective clinical instruction identified in this study align with durable themes that emerged in prior research on clinical education across health professions. Students felt that the most effective clinical teaching strategies incorporate aspects from the five identified themes. Although these themes may help guide better clinical teaching approaches, individual student needs and the most effective clinical education strategies will vary for each student. These findings can be incorporated into audiology clinical instructor training and practices, ensuring clinical education strategies that align with student learning needs.

Supplemental material: https://doi.org/10.23641/asha.31049815.

Purpose: Hearing loss impacts 430 million individuals worldwide and is linked to negative outcomes such as social isolation and cognitive decline. While social media offers a valuable avenue for gathering insights into patient experiences with hearing aids (HAs) and cochlear implants (CIs), there remains a significant gap in understanding how to effectively capture and analyze these perspectives. This scoping review aims to map existing literature about online communities, providing a novel approach to exploring and analyzing patient experiences with HAs and CIs that conventional research methods may overlook.

Method: A comprehensive literature search was conducted across several databases to identify studies evaluating HA and CI user experiences with regard to online platforms. Studies were screened and summarized, drawing out themes for user devices studied, digital platforms utilized, and primary analysis methods.

Results: Of 1,752 original studies screened, 16 were ultimately included. Three primary modes of analysis emerged from a review of the literature: (a) manual coding of text, (b) computational text analysis, and (c) audiovisual content analysis. Each approach contributed distinct insights: Manual coding captured nuanced lived experiences and emotional narratives, computational techniques offered scalable assessments of sentiment and usage patterns, and audiovisual analyses highlighted educational quality and content dissemination trends. Findings revealed underlying trends in the utility of online communities as a space for patients with a CI or HA to share personal anecdotes and experiences, as a modality to distribute medical information and decrease barriers to health literacy, and as a unique environment to find peer support.

Conclusions: This scoping review demonstrates promise in the use of online platforms as a resource for evaluating HA and CI user experiences. Evaluating these digital platforms can help inform patients and guide providers with user perspectives, offer support systems for patients, and empower patients with a CI or HA to optimize their medical, communicative, and social engagement throughout their hearing health care journey.

Supplemental material: https://doi.org/10.23641/asha.31060957.

Purpose: This study examined how cognitive skills (nonverbal intelligence, verbal working memory, and attention) influence academic performance in children with minimal to mild conductive hearing loss (mCHL) and whether this relationship is moderated by subjective fatigue and listening effort. We also compared these effects with age- and sex-matched children with normal hearing sensitivity (NHS).

Method: A cross-sectional correlational study was conducted on 130 children with mCHL and 130 children with NHS (aged 10-12 years). Audiological testing, cognitive assessments (Seguin form board test, digit span, operation span, and dichotic digit tests), and subjective fatigue ratings (visual analog scale) were collected. Listening effort was measured using a dual-task paradigm that involved speech-in-noise and digit-reversal tasks. Teachers rated academic performance using the Academic Performance Rating Scale and supported by recent academic marks. Multiple linear regression and moderation analyses were performed.

Results: Children with mCHL exhibited significantly higher listening effort, greater subjective fatigue, lower cognitive scores, and poorer academic performance than their peers with NHS did. Moderation analysis revealed that subjective fatigue significantly weakened the positive relationship between cognition and academic performance in children with mCHL but not in children with NHS. A z test confirmed that the moderating effect was significantly stronger in the mCHL group.

Conclusions: These findings suggest that subjective fatigue plays a critical role in modulating the effects of cognition on academic success in children with mCHL. Interventions addressing listening efforts and fatigue management are suggested for improving educational outcomes in this population.

Supplemental material: https://doi.org/10.23641/asha.31057807.

Purpose: Tinnitus is the perception of sound that cannot be attributed to an external source, which can be distressing. There are several measures of tinnitus distress available; however, these measures are difficult to use in practice. The Tinnitus Severity Short Form (TS-SF) was developed to be a brief, pragmatic measure. However, it is presently unclear whether the measure may be invariant across groups.

Method: Participants (N = 277) completed the TS-SF. Confirmatory factor analysis and measurement invariance analyses were run in Mplus.

Results: A confirmatory factor analysis demonstrated acceptable relative fit indices for a bifactor model. The TS-SF demonstrated measurement invariance at the configural, metric, scalar, and residual levels between veterans and civilians. Post hoc testing indicated that a vast majority of the variance of the bifactor model can be attributed to the substantive distress score, justifying unifactorial scoring.

Conclusion: This study provides evidence that the TS-SF is a useful, brief measure of tinnitus distress that may be used to connect individuals to appropriate treatments.

Purpose: Controlled clinical trials demonstrate the safety and efficacy of new treatments, but real-world outcomes may vary due to patient diversity and treatment variations. Tinnitus, affecting 10%-15% of the population, is a major health concern. Lenire, a bimodal neuromodulation treatment combining sound and tongue stimulations, has shown safety and effectiveness in clinical trials. This study presents the first real-world evidence (RWE) from a U.S. cohort that investigates tinnitus subgroup severities, providing further assessment of Lenire's use in clinical practice.

Method: A single-site, single-arm chart review of 140 patients treated between May 1, 2023, and January 19, 2024, was conducted. Patients were prescribed Lenire for up to 60 min daily and attended follow-ups at 6 and 12 weeks.

Results: This is the first study in a U.S. cohort to show results consistent with the U.S. Food and Drug Administration (FDA) labeling of Lenire, where positive therapeutic outcomes were achieved in patients with moderate or worse tinnitus severity as measured by the Tinnitus Handicap Inventory (THI). In this bothered tinnitus group, 81.8% (95% CI [70.9%, 89.3%]) achieved a clinically significant response (THI improvement ≥ 7 points) to treatment, with a mean reduction of -23.8 ± 2.3 points after only 12 weeks of treatment. In contrast, when providing Lenire treatment to tinnitus patients with less bothersome tinnitus (i.e., slight and mild categories), nearly zero change in score, on average, was observed after treatment. Additionally, responder rates based on an alternative threshold of at least an 11-point reduction in THI score show a high response to treatment even with this stricter minimal clinically important difference criterion, with 71.2% (95% CI [59.4%, 80.7%]) of the participants meeting or exceeding the threshold. Similar results were observed when using an alternative threshold based on an intrasubject percent improvement, defined as a reduction of at least 15% from each participant's THI score at the initial assessment.

Conclusions: Real-world data support Lenire's clinical benefits for patients with moderate or more severe tinnitus and demonstrate consistency with clinical trial results that led to FDA approval. These findings further confirm its successful integration into standard audiology care. Ongoing RWE collection will help identify the most responsive patients and guide tailored treatments.

Supplemental material: https://doi.org/10.23641/asha.31028449.

Purpose: Limited access to qualified professionals prevents children and adults with hearing loss from receiving timely care needed to mitigate the insidious impacts of hearing loss. Previous studies note the U.S. audiology workforce (~14,400 in 2022) is insufficient for meeting the growing hearing health care needs of the American population. The objective of the present study is to characterize the geographic dispersion of audiologists in Texas and to compare sufficiency using various benchmarks for identifying hearing health care shortage areas in the state.

Method: For each of the 254 Texas counties, geographic hearing health accessibility was assessed as a binary outcome (sufficient, insufficient) using three published provider-to-population ratio benchmarks (1:3,500 [primary care physicians]; 1:5,000 [dentists]; and 1:10,000 [educational audiologists]). Workforce sufficiency of licensed audiologists was then compared across Texas public health service regions (PHSRs), rurality categories, and U.S.-Mexico border designations.

Results: Results indicated that the audiologist workforce in Texas is insufficient to meet the hearing health care needs of the population in 96% of counties (244 of the 254). Most PHSRs were understaffed, with the exception of select counties in the Dallas metro area. Access to licensed audiologists was consistently limited, regardless of rurality or proximity to the U.S.-Mexico border.

Conclusions: The audiology workforce in Texas is insufficient to meet the hearing health care needs of the population. State-level public health, regulatory, and educational policies should prioritize addressing workforce shortages and audiology "deserts." Provision of audiology services via telehealth also represents a promising strategy for improving access in areas where no provider is present.

Supplemental material: https://doi.org/10.23641/asha.30781130.

Purpose: The purpose of this study was to evaluate the benefit of the Apple AirPods Pro 2 Live Listen feature on speech recognition and recall in noise among older adults in a controlled laboratory setting.

Method: Twenty adults aged 60-90+ years completed a modified speech-in-noise task with and without AirPods using the Live Listen feature. A Quick Speech-in-Noise Test-derived task measured recognition and recall under both conditions. Participants also completed audiometric screening, working memory assessment, and signal-to-noise ratio (SNR) loss estimation. Paired t tests and multiple regression analyses were used to assess performance differences and predictors.

Results: Participants demonstrated significantly higher speech recognition (p < .00001) and recall (p = .00023) when using Live Listen. Recognition improvements were predicted by age, SNR loss, and sex, while recall improvements showed no significant predictors.

Conclusions: The Live Listen feature of the Apple AirPods Pro 2 significantly improved speech-in-noise performance in older adults. These preliminary findings support its potential as an affordable assistive tool in noisy environments, such as hospitals, where traditional hearing aids may be unavailable.