American Journal of Audiology最新文献

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.

Purpose: Cochlear implant (CI) recipients who listen with a hearing aid (HA) in the contralateral ear, known as bimodal listeners, demonstrate individual variability in speech recognition in noise. This variability may be due in part to differences in the processing delays of the CI and HA devices. This study investigated the influence of matching the processing delays of CI and HA devices on masked speech recognition for bimodal listeners.

Method: Twelve postlingually deafened adult CI recipients completed a task of masked speech recognition in two listening conditions: (a) independent default CI and HA processing delays (mismatched) and (b) with their HA-specific delay applied to the CI processing delay (matched). Speech recognition was evaluated with AzBio sentences presented in a 10-talker masker at a 0 dB SNR. The target was presented from the front loudspeaker at 0° azimuth, and the masker was co-located with the target, presented 90° toward the CI ear, or presented 90° toward the HA ear.

Results: There was a significant main effect for target-to-masker configuration, with better performance when the masker was spatially separated from the target. Better masked speech recognition was observed in the matched condition as compared to the mismatched condition.

Conclusion: Bimodal listeners may experience better masked speech recognition when the processing delay of the CI is individualized to match the processing delay of the contralateral HA.

Supplemental material: https://doi.org/10.23641/asha.27616845.

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.

Purpose: While general practice parameter recommendations for children with unilateral hearing loss or single-sided deafness (SSD) have been published, clinically utilized subjective instruments specifically designed to assess this population are scarce. Treatment options are evaluated using audiometric data, speech perception data, and quality of life instruments. The Unilateral Hearing Loss in Youth (uniHELO) is a subjective assessment instrument that aims to evaluate the listening challenges in this population, but it has not yet been studied in a clinical setting. This study examined the reliability of the uniHELO among children with SSD.

Method: This was a prospective within-subject study. Nine patients with SSD, aged 8-14 years, were enrolled. Participants had not used a personal hearing device for at least 6 months prior to enrollment. The uniHELO instrument was administered at two clinic visits separated by 3-4 weeks. For comparison, the Pediatric and Parent Speech, Spatial, and Qualities of Hearing Scale (SSQ) instruments were administered during the same visits.

Results: uniHELO scores were not significantly different between the first and second visits. The correlations of scale scores over time were: .96 for the uniHELO, which suggests excellent test-retest reliability; .84 for the Parent SSQ, which also suggests excellent test-retest reliability; and .27 for the Pediatric SSQ, which suggests poor test-retest reliability compared to the Parent SSQ and uniHELO.

Conclusions: Within-subject scale uniHELO scores between clinic visits showed excellent test-retest reliability across items. The test-retest reliability scores for the uniHELO were also stronger than those for the Parent and Pediatric SSQ. These data support the use of the uniHELO to evaluate listening challenges in children with SSD.

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 V^th 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.

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.

Purpose: Hearing loss (HL) is a leading cause of disability worldwide, but its health-related costs have been incompletely studied. Our objective was to examine the association between HL and direct health care costs and identify subgroups in which costs associated with HL are especially high.

Method: This was a retrospective population-based cohort study of adults treated in a universal health care system between April 2008 and March 2019. HL was identified using administrative health data. We estimate health care costs in 2023 Canadian dollars, including costs for hospitalization, provider claims, ambulatory care visits, prescription medications, and long-term care (LTC).

Results: Of 4,424,632 participants, 146,644 (3.3%) had HL. Participants with HL were older (Mdn = 55 years [interquartile range: 43-68] vs. 35 years [24-50]) and had more comorbidities (1 [0-2] vs. 0 [0-1]) at baseline than participants without, whereas the likelihood of female sex, rural residence, and material deprivation were similar between groups with and without HL. Over median follow-up of 11.0 years, total age-sex adjusted annual health costs and each of its component costs were significantly higher in participants with HL compared to those without (annual total costs: $6,871, 95% confidence interval [CI] [$6,778, $6,962] vs. $4,716, 95% CI [$4,729, $4,763]). After full adjustment (a maximum of 29 comorbidities), annual costs remained significantly higher in participants with HL overall and for certain subcomponents (provider claims, ambulatory visits, and medications), whereas adjusted costs of hospitalization and LTC were lower among people with HL. The magnitude of the incremental costs among participants with HL was most pronounced for younger participants, men, or those with less comorbidity. Total projected annual direct health costs for Alberta residents with HL were $1.01 billion in 2023, of which $125 million (95% CI [$116, $135 million]) was attributable to HL specifically.

Conclusions: Compared to those without HL, health costs were markedly higher among participants with HL, partially due to a higher burden of comorbidity. The relatively high population attributable costs of HL suggest that better prevention, recognition, and management of this condition could yield substantial economic benefits.

Supplemental material: https://doi.org/10.23641/asha.27353439.

Purpose: The aim of the study was to evaluate whether behavioral speech-in-noise (SiN) benefits of hearing aid directivity based on multistream architecture (MSA) might result in reduced electroencephalographic activity in the alpha-band, as is often associated with task difficulty.

Method: A single-blind within-subject design was used in this study. Thirteen older adults (M_age = 73.5 years, range: 62-82 years, six women) with sensorineural hearing loss participated in the study. Participants wearing study hearing aids first performed an adaptive sentence-level SiN test in an MSA-enabled condition (i.e., MSA-ON) to determine the signal-to-noise ratios (SNRs) corresponding to speech reception thresholds for 50% correct performance (i.e., SRT-50s). Participants were then tested at their individualized SNRs with target sentences alternating on each trial between two loudspeakers positioned in the front at 0° and -30° azimuth, such as to simulate turn-taking between two talkers seated across from the listener. Electroencephalographic activity was recorded as participants performed this SiN test in two hearing aid conditions: MSA-OFF and MSA-ON.

Results: Neural oscillations in the alpha-band were significantly reduced over centroparietal electrode sites when listeners performed SiN testing in MSA-ON versus MSA-OFF conditions. Alpha-band power was also observed to increase significantly over the course of 60 test trials, possibly indicative of listener fatigue. Reductions in alpha-band power were not significantly related to likewise improvements in SiN performance.

Conclusions: Hearing aid directivity based on the MSA algorithm resulted in significantly lower neural activity associated with listening task difficulty in a simulated multitalker situation. Although these results align with the behavioral SiN improvements associated with MSA, magnitudes of change in alpha-band power did not correlate with the degree of behavioral benefit at the level of individual listeners. Measuring neural oscillations in the alpha-band might be useful for evaluating and gaining greater insight into the impact of hearing aid processing on listening effort in challenging acoustic environments.

Purpose: The purpose of the present study was to develop and evaluate an in-person hearing aid training program designed for health care workers and personal care aides (PCAs) who care for older adults.

Method: Participants were 18 health care workers and PCAs whose clients were older adults. This was a randomized controlled study in which half of the participants were assigned to the experimental group (n = 9) and the other half to a control group (n = 9). The experimental group was administered a hearing aid training program that was developed in this study for health care workers and PCAs. Participants in the control group were trained on a task similar in complexity and administration time to the hearing aid training program. The Practical Hearing Aid Skills Test-Revised Version 2 (PHAST-Rv2) was administered before and immediately after training. A 2 × 2 mixed analysis of variance (ANOVA) was used to compare the pre- and post-training scores between and within the experimental and control groups. Descriptive statistics were used to examine the differences between pre- and post-training scores on each of the administered PHAST-Rv2 tasks. In addition, participants were asked about their experience helping clients with their hearing aids.

Results: Mean pre- and post-training PHAST-Rv2 scores for the experimental group were 59.50% and 95.84%, respectively, and 57.66% and 59.96%, respectively, for the control group. Results from a 2 × 2 mixed ANOVA with time point (pre- and post-training) as the within-subject variable and group (experimental and control) as the between-subject variable demonstrated that hearing aid training significantly improved PHAST-Rv2 scores for the experimental group. Post-training, the tasks that the experimental group improved on the most were brushing the microphone port, cleaning the dome, placing the hearing aids in the charger, and inserting the hearing aid into the model ear. No demographic variables were significantly correlated with the participants' improvement on the PHAST-Rv2 post-training score.

Conclusion: A hearing aid training program designed specifically for health care workers was shown to be an efficient and effective way to improve how well health care workers can care for and operate a hearing aid.

Purpose: The aim of this study was to describe the audiological test results from a sample of 60 adults with self-reported misophonia.

Method: Audiological testing was completed prior to participant randomization in a controlled trial for misophonia treatment. Participants completed the Inventory of Hyperacusis Symptoms Survey (IHS), the Tinnitus and Hearing Survey (THS), the Misophonia Questionnaire (MQ), and behavioral and objective audiometric measures.

Results: Hearing thresholds were less than 25 dBHL for 97% of the participants. Loudness discomfort levels for tonal stimuli suggested hyperacusis in 25% of the sample. Total scores on the IHS indicated that 12% met the clinical cutoff for hyperacusis, and, on the THS, 27% experienced problems with tinnitus, 77% experienced problems with hearing, and 53% experienced problems with sound tolerance. On the MQ, 37% indicated mild levels of misophonia and 58% indicated moderate levels. For speech-in-noise testing, a mild signal-to-noise ratio loss was present for 15% of participants. Most of the participants had present distortion product otoacoustic emissions (DPOAEs).

Conclusions: Audiological data on individuals with misophonia are lacking. In this article, we present results from audiological testing on 60 adults with self-reported misophonia. Most had normal peripheral hearing sensitivity based on pure-tone audiometry and DPOAE measures; some had difficulties with sound sensitivities and understanding speech-in-noise, self-report indicated problems with hyperacusis, tinnitus, and hearing difficulty.