American Journal of Audiology最新文献

Purpose: The purpose of this study was to provide proof of concept for at-home measurements of the tinnitus spectrum.

Method: Nineteen participants completed pitch similarity ratings in the laboratory and at home. All participants first completed laboratory tests (at 500-16000 Hz) and then later completed at-home tests (at 250-8000 Hz) using their own personal computers and headphones. Six participants repeated these measurements after at least 3 weeks.

Results: Tinnitus spectra (plots of pitch similarity rating vs. frequency) were analyzed using linear regression and Bland-Altman plots for frequencies that were common to both environments (500-8000 Hz). Although the Bland-Altman plots indicated that absolute ratings used by participants differed in the two settings with online ratings tending to be higher than lab ratings, the regression analysis indicated that the tinnitus spectra had similar shapes (evidenced by significantly positive slopes) between the two environments for 14 of the 19 participants. Similar results were evident for test-retest reliability of the six returning participants in both settings.

Conclusions: We conclude that the pitch similarity rating method is potentially viable for measuring tinnitus pitch at home. At-home implementation could expedite clinical tinnitus assessments and could be used in conjunction with at-home implementations of tinnitus treatment strategies. However, future studies should include participants who are tested at home prior to being tested in the lab and include an evaluation of extended high frequencies at home.

Background and objectives: Hearing loss is relatively common in older individuals, and individuals with frontotemporal lobar degeneration (FTLD) are no exception; this can exacerbate communication difficulties stemming from speech-language impairments. The co-occurrence of these symptoms can contribute to increased frustration and isolation for patients and their communication partners. The objective of this study was to evaluate the feasibility of self-administered hearing testing. Ultimately, this could be administered remotely, which would increase access to assessment and inform management for this population.

Method: Seventeen patients with underlying FTLD, clinically presenting with progressive apraxia of speech with and without agrammatic aphasia, independently completed the Home Hearing Test supervised while in office.

Results: Three patients self-reported hearing loss, but results for 100% recommended formal evaluation. Eleven patients demonstrated good test accuracy. Six patients had "poor" or not computable accuracy; among them, five had evidence of cognitive impairment and/or behavioral changes, and one had known severe hearing loss, although differences between those with good and poor test accuracy were not significant. Patients with poor test accuracy had more difficulty with limb praxis.

Conclusions: Most participants independently completed the test, though some had reduced test accuracy that may have been associated with cognitive impairment and/or limb apraxia. This study supports the need for hearing screenings in all patients with progressive apraxia of speech and aphasia and highlights both the feasibility and caution required in implementing self-administered testing protocols. Further work should evaluate the feasibility of in-home hearing screenings in a broader range of FTLD phenotypes and directly compare sensitivity and specificity of hearing loss detection with in-clinic administration.

Supplemental material: https://doi.org/10.23641/asha.28306613.

Purpose: This study aimed to profile and compare the auditory processing and working memory skills of young and older adults with near-normal hearing thresholds (up to 2000 Hz) and cognition. This was done to investigate the effect of aging on these skills despite exhibiting near-normal peripheral hearing in low frequencies and normal cognitive skills.

Method: Twenty-five young adults (18 to 35 years) and 35 older adults (56 to 79 years) were recruited for the study. They were screened for near-normal hearing thresholds (up to 2000 Hz) as well as cognition, and written informed consent was obtained. A battery of auditory processing and working memory tests were administered to the participants. The responses obtained were compared using the Mann-Whitney U test. Principal component analysis (PCA) was also carried out to examine any relationship between the various auditory processes and the cognitive skills.

Results: The young adults had superior performance compared to older adults on most of the tasks. PCA revealed the influence of working memory on performance in most tests of auditory processing in young adults and to a lesser extent in older adults.

Conclusions: This study aimed to assess and compare the auditory processing and working memory skills of young and older adults with normal hearing and cognition. Overall, young adults demonstrated superior performance compared to older adults across the tasks. The results of PCA indicated that the young adults utilized their cognitive resources better for auditory processing compared to the older adults. These findings suggest a need for tailored interventions targeting both auditory processing and working memory, especially among older adults, and highlight the importance of considering age-related differences in these cognitive processes when interpreting auditory processing assessments.

Purpose: Diabetes affects the peripheral auditory and vestibular systems. Research suggests that both cervical vestibular evoked myogenic potentials (cVEMP) and ocular VEMP (oVEMP) are affected in individuals with diabetes. Masseter VEMP (mVEMP) is a new tool that assesses the vestibulomasseteric reflex pathways. The study aimed to characterize the cVEMP and mVEMP latency and amplitude parameters in diabetes mellitus type 2.

Method: The study included 21 participants with type 2 diabetes mellitus and 21 age- and gender-matched participants without diabetes aged 48-68 years. mVEMP and cVEMP were recorded using 500 Hz tone burst stimuli, presented at an intensity of 125 dB peSPL for both the groups.

Results: The study suggests significantly prolonged P13 (p = .00) and P11 latencies (p = .00) in participants with diabetes (M for p11 = 15.81, M for p13 = 15.39) compared to participants without diabetes (M for p11 = 13.12, M for p13 = 14.19) for both cVEMP and mVEMP, respectively. No significant differences were observed in N23 (p = .4) and N21 latencies (p = .18) between the diabetes (M for N21 = 22.62, M for N23 = 22.61) and nondiabetes groups (M for N21 = 22.21, M for N23 = 22.40). Additionally, a significant reduction in cVEMP amplitude (P13-N23) was noted in the diabetes group (M for P13-N23 = 0.71, p = .00) than the nondiabetes group (M = 1.44), while mVEMP amplitudes (P11-N21) remained similar across groups (M for P11-N21 for diabetes = 0.72, (M for P11-N21 for nondiabetes = 0.77, p = .44). There were no significant correlations between the duration of diabetes and VEMP parameters, nor between cVEMP and mVEMP responses in either group.

Conclusions: The findings revealed notable differences in cVEMP and mVEMP findings in diabetes individuals. These results suggest that diabetes may lead to neural and labyrinthine impairments. The degree of vestibular impairment varies and affects different reflex pathways. Even though mVEMP has a similar saccular origin as cVEMP, the results between the two do not correlate with each other.

Purpose: The majority of college-level musicians exceed the daily recommended noise dose level during instrumental practices and performances, although less than one third report wearing hearing protection while playing their instruments. Although the hazardous effects of music on the auditory system have been established, even in young adult musicians still early in their musical careers, the effects of music on the vestibular system are still unclear. The purpose of the present study was to examine vestibular/balance differences between young adult musicians and nonmusicians to determine the effects of music exposure on the vestibular system.

Method: Young adult participants aged 18-27 years without any history of hearing loss, vestibular/balance disorder, otologic disorder, or nervous system disorder were included in this study. Participants were divided into musician (n = 19) and nonmusician (n = 18) groups. Vestibular function was assessed and compared via the cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), video head impulse test (vHIT), and modified clinical test of sensory interaction in balance (mCTSIB).

Results: Musicians were found to produce significantly more saccades in the left horizontal semicircular canal during vHIT assessment compared to nonmusicians. Group differences were not found in the cVEMP, oVEMP, or mCTSIB.

Conclusions: This study shows the effects of music exposure on the vestibular system in young adult musicians who show early-onset, subclinical findings on the vHIT that could develop into abnormal results on vestibular assessments if hearing protection use is not increased.

Objective: The purpose of this study was to describe the factors related to dizziness in workers with noise-induced hearing loss in Brazil.

Method: A cross-sectional study was carried out with a sample from noise-induced hearing loss reports (2007-2019). The dependent variable in this study was dizziness, and the independent variables were sociodemographic characteristics, comorbidities, symptoms, and noise characteristics in the work environment. Logistic regression analysis was performed.

Results: A total of 3,824 individuals with noise-induced hearing loss in Brazil were analyzed. The prevalence of dizziness was 23.4% in the sample. Factors associated with dizziness were women (odds ratio [OR]: 2.10; 95% confidence interval [CI] [1.64, 2.69]), hypertension (OR: 1.68; 95% CI [1.38, 2.06]), headache (OR: 6.31; 95% CI [5.26, 7.57]), tinnitus (OR: 3.46; 95% CI [2.82, 4.25]), and continuous noise at the work environment (OR: 1.54; 95% CI [1.22, 1.94]).

Conclusions: The factors associated with the outcome-dizziness-were gender (female), systemic arterial hypertension, headache, tinnitus, and continuous exposure to workplace noise. Such findings demonstrate the importance of promoting a multifactorial approach to understanding dizziness among workers exposed to occupational noise.

Purpose: Limited accessibility to hearing health care threatens healthy aging in place for older adults with hearing loss. A willingness-to-pay (WTP) approach was used to determine benefits and value of prescription advanced digital technology (ADT) hearing aids, over-the-counter (OTC) hearing devices, and rehabilitative services using benefit-cost analyses.

Method: This study was a cross-sectional survey with chart review of hearing aid users at two independent audiology practices. Seventy hearing aid users (response rate: 15.6%) provided their WTP for ADT prescription hearing aids, OTC hearing devices, and hearing rehabilitative services. Benefit-cost ratios and net social benefit were calculated using deterministic and exploratory approaches. Point estimates for benefit-cost ratios and net social benefit were derived using bootstrap sampling with replacement (N = 5,000).

Results: Median WTP for ADT prescription hearing aids and rehabilitative services were $2,000 and $250, respectively. WTP was lowest for OTC devices (Mdn = $0; maximum = $500). Benefit-cost ratios and net social benefit for ADT prescription hearing aids, OTC devices, and hearing rehabilitative services favored these interventions when out-of-pocket costs remained low. Benefit-cost analyses also produced results favoring prescription ADT hearing aid intervention with costs as high as $1,530 per device.

Conclusions: WTP results indicated that all interventions under study have a measurable consumer-perceived benefit. Results of benefit-cost analyses favored the interventions but only when costs were lower than market prices. The benefit-cost analysis results for hearing care services underscore their value when provided as part of a comprehensive rehabilitative plan that may inform future health policy changes.

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.

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.

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.