Journal of the American Academy of Audiology最新文献

Background: Pulsatile tinnitus (PT) is a form of tinnitus described as a rhythmic beating or whooshingin the ear or ears. Causes of PT can be quite variable and difficult to assess.
Purpose: Ambient pressure tympanography (APT) can aid in diagnosing the pathology of the temporalbone that may cause PT. APT measures compliance of the tympanic membrane (TM) over the span of15-60 s with ambient pressure in the ear canal. The reflex decay test protocol includes APT to measurechanges in admittance with a tonal stimulus. Using a contralateral reflex decay test setup withoutthe use of a contralateral stimulus (outside of the ear at 75 dB), any movement of the tympanic membranemay be considered internally produced.
Research Design: When a patient experiences tinnitus that is nonpulsatile, contralateral reflex decay testingwithout the stimulus tone should reveal a flat-line recording because there is no change in pressure orvolume of the middle ear space caused by the stimulus. When a patient experiences PT, the TM mayappear to be moving rhythmically secondary to pressure and volume changes in the middle ear space.
Study Sample: Three adult patients (age older than 18 years) who recently presented to an audiologyand otolaryngology clinic and reported PT symptoms were evaluated using APT.
Intervention: Interventions were not studied during this case series.
Data Collection and Analysis: GSI TympStar Pro Equipment measured TM movement over 15-s intervals.Contralateral reflex decay test settings were utilized with the contralateral stimulus reduced to 75 dB and keptoutside of the patient's ear canal to avoid stimulating the system. The measuring probe tip was inserted in thesymptomatic ear canal to maintain pressure and observe any internal movement in the middle ear.
Results: APT of our patient cohort revealed fluctuating changes in the middle ear cavity volume with arhythmic pattern that corresponded with the heartbeat. Imaging studies that were performed for eachpatient demonstrated the likely cause of PT.
Conclusion: APT is an efficient clinical tool used to evaluate PT. If a rhythmic change in admittancethat corresponds with the patient's heart rate is noted, then further imaging of the temporal bone todetermine possible causes may be warranted.

Background: Labyrinthitis, an inner ear infection affecting the membranous labyrinth, typically presentswith symptoms such as dizziness, nausea, vomiting, tinnitus, and hearing loss. However, there is limitedepidemiological data on this condition.
Purpose: This case report presents the results of audiovestibular evaluation and vestibular rehabilitationregarding unilateral sudden hearing loss and acute vestibular syndrome caused by rare labyrinthitisin a pediatric patient.
Research Design: This is a case report.
Study Sample: The study sample included a 5-year-old girl with unilateral sudden hearing loss andacute vestibular syndrome.
Results: The patient with labyrinthitis, diagnosed early after comprehensive audiological and vestibularevaluation, benefited from medical treatment and vestibular rehabilitation.
Conclusions: This report objectively focuses on the importance of early medical treatment, regularaudiovestibular follow-up, and vestibular rehabilitation in a pediatric patient with labyrinthitis.

Background: High prevalence of hearing loss and its physical, mental, and social impacts when unaddressedunderscore a need for early identification. However, in-person hearing assessment may beinaccessible in certain countries and areas. As such, numerous smartphone-based and web-basedapplications (apps) have been developed to perform remote hearing assessment, and yet many ofthem remain unvalidated.
Purpose: The purpose of this study was to evaluate the performance, ecological validity, and usabilityof two freely available smartphone-based hearing assessment apps-Hearing Test (Android) and MimiHearing Test (iOS)-alongside a web-based app, MDHearing Aid.
Research Design: This is a cross-sectional validation study.
Study Sample: This study included 60 adults with hearing thresholds no greater than 20 dB HL or anydegree of sensorineural hearing loss.
Data Collection and Analysis: Participants completed standard audiometric testing followed byassessments using three apps in a controlled laboratory setting. The assessments were repeated byparticipants at home the subsequent day. The mHealth App Usability Questionnaire (MAUQ) wasadministered to evaluate the apps' usability. Performance metrics included sensitivity, specificity, accuracy,and test-retest reliability. Intraclass correlation coefficient (ICC) estimates were calculated tomeasure the apps' accuracy, test-retest reliability, and ecological validity.
Results: All apps had moderate to good sensitivity (0.67-1.00) and specificity (0.72-0.99). The HearingTest app showed poor accuracy at lower frequencies (ICC: 0.24-0.53) and moderate to good accuracy above 1000 Hz (ICC: 0.74-0.83). The Mimi Hearing Test showed poor accuracy at lower frequencies(ICC: 0.27-0.50) and moderate to good accuracy above 2000 Hz (ICC: 0.68-0.85). The web-basedMDHearing Aid test showed moderate to good accuracy across frequencies (ICC: 0.64-0.85). All appshad moderate to excellent test-retest reliability (ICC: 0.66-0.99) and showed poor ecological validity below500 Hz (ICC: 0.20-0.51) and moderate to excellent ecological validity above 1000 Hz (ICC: 0.54-0.95).Usability was rated highly across all apps, with MAUQ scores ranging from 5.4 to 5.9 out of 7.
Conclusions: The examined apps exhibit varied accuracy levels and generally reasonable sensitivity,specificity, test-retest reliability, ecological validity, and usability. With additional validation, the HearingTest app may be useful for hearing screening and monitoring in adults. There is a necessity for furtherresearch to unlock the examined apps' full clinical potential.

Background: Dominant deafness-onychodystrophy (DDOD) syndrome is a rare genetic disorder characterizedby sensorineural hearing loss and the absence or hypoplasia of nails, associated withdefects in the ATP6V1B2 gene. This gene defect significantly affects hearing function, leading to congenitalsevere-to-profound hearing loss.
Purpose: We present the comprehensive cochlear implant (CI) outcome of a 5-year-old child withDDOD syndrome who received bilateral sequential CIs at the ages of 1 and 4 years.
Research Design: Case study.
Data Collection and Analysis: Retrospective chart review of aural-communication and languageperformance.
Results: After the follow-up following the first CI, there was improvement in auditory, language, andcognitive abilities. At 41 months after the first CI, the child received the second CI. Although his languageability still lagged behind, his auditory and communication performance continued to improveafter bilateral CI surgery. He obtained 95 percent on the Parents' Evaluation of Aural/Oral Performanceof Children scale at the last follow-up.
Conclusions: Children with DDOD syndrome (ATP6V1B2 c.1516C > T) receiving bilateral CIs canenhance aural and communication skills.

Background: Since the development of word-recognition materials to test the transmission properties ofauditory devices and human auditory systems, a carrier sentence or phrase (e.g., Say the word) has beenused to preface the test word. For practical reasons, only the amplitude of the carrier phrase was somewhatcontrolled. The current American National Standards Institute standard for audiometers continues tospecify the level of the test word should be the same communication level as the carrier phrase.
Purpose: The development of an amplitude calibration protocol for use with short-duration speech signalsthat are characterized by substantial amplitude modulations is described.
Research Design: Protocol 1 evaluated the average maximum root-mean-square (rms) amplitudes of12.5-, 25-, 50-, and 100-ms voiced phoneme segments of each test word in 0.0227-ms increments todetermine the segment duration to use. Protocol 2 used the 50-ms segment with the maximum rmsamplitude among the 200 words in each list to normalize independently the amplitudes of the carrierphrases and test words to a target rms amplitude for each speaker.
Study Sample: Digital copies of the 200 monosyllabic words in three versions of Northwestern UniversityAuditory Test No. 6 (NU-6) and one version of the W-22 each spoken by a different speaker wereevaluated using the numeric digital values transcribed from the audio files. Two iterations of the protocolwere compiled.
Data Collection and Analysis: In-house routines were used to analyze the waveform data, the resultsof which were evaluated with central tendency statistical analyses.
Results: The finalized protocol is based on the rms amplitude of a 50-ms segment of the sustained,voiced phoneme of each test word. The protocol directly links the rms amplitudes of the calibrationtone and of the 50-ms word segments as opposed to the currently used linking of the calibration tonerms amplitude to a peak meter deflection of the carrier phrase from which the amplitude of the testword is inferred.
Conclusions: The effectiveness of the calibration protocol was demonstrated successfully on the foursets of word-recognition materials. The rms amplitude adjustments made independently to the individualcarrier phrase and test-word utterances produced overall rms amplitudes for each of the four speakersthat were homogenized slightly for the carrier phrases but substantially for many of the test words.
Clinical Relevance Statement: The calibration protocol described provides an objective procedurethat can be implemented and, most importantly, replicated with numeric accuracy to equate test-word(and carrier phrase) amplitudes among short speech signals like monosyllabic words and amongspeaker versions of those materials.

Purpose: The aim of this study was to examine the efficacy of auditory training to improve cognitivefunction in patients with age-related hearing loss (ARHL).
Research Design: This is a systematic review and meta-analysis.
Study Sample: Seven studies involving 443 participants met the inclusion criteria. Participants were typicallyolder adults (mean age = 67.23 years, standard deviation = 7.14) with mild to severe hearing loss.
Intervention: Auditory training includes speech perception training, phoneme discrimination training,and so on.
Data Collection and Analysis: A literature search of academic databases (Cochrane Library,PubMed, Web of Science, Embase, Wanfang, Weipu, and China National Knowledge Infrastructure)identified relevant articles published up to December 2023. This review includes only randomized controlledtrials. The primary outcome is cognition function, measured by Montreal Cognitive Assessment,Mini-Mental State Examination, and other cognition-related subtest indicators.
Results: The overall effect of auditory training on overall cognition and executive function in ARHL isstatistically significant (overall cognition: g = 0.79, 95 percent confidence interval [CI]: 0.57, 1.01;executive function: g = 3.84, 95 percent CI: 1.49, 6.19), but executive function domain has high heterogeneity(I2 = 100 percent). The effect of auditory training on attention/processing speed and workingmemory is small and not significant (attention/processing speed: g = 1.47, 95 percent CI: -0.48, 3.42;working memory: g = 0.68, 95 percent CI: -2.22, 3.58), but both attention/processing speed (I2 = 96percent) and working memory domain (I2 = 98 percent) have high heterogeneity.
Conclusions: The overall impact of auditory training on overall cognition and executive function seemsto be significant, but because of the low quality of the literature and certain biases, it is impossible to conclude that auditory training can improve the cognitive function of ARHL; therefore, more high-qualityevidence is needed.

Objective: CHARGE syndrome (CS) is a genetic disorder caused by pathogenic variants within chromodomainhelicase DNA-binding protein 7 (CHD7). The classical presentation includes coloboma,congenital heart defects, atresia of the choanae, retardation of development, genital hypoplasia, andear anomalies. Clinical presentation varies widely by type and severity. Structural anomalies of the earcause hearing loss in 93 percent of individuals with CS. Factors to predict the type and degree of hearingloss among individual patients with CS have not been identified. Identifying factors would ensure patientsreceive early intervention and allow health care providers to accurately counsel on expectations.
Research Design: To identify factors correlated with certain types and degrees of hearing loss, a retrospectivechart review of 57 pediatric individuals with CHD7 disease-causing variants from theCHARGE Center at Cincinnati Children's Hospital Medical Center was conducted. All data were manuallyextracted from participants' medical records, as well as the CHARGE Clinic REDcap database.Type and degree of hearing loss were compared to the type of CHD7 variant and craniofacialanomalies.
Results: Within our cohort, 97 percent of individuals experienced hearing loss (HL), with sensorineural(SNHL) being the most common type. Eighty-three percent experienced severe-to-profound HL in atleast one ear, a higher prevalence than previously reported. Temporal bone scan results were availablefor 34 participants with HL, and structural anomalies were seen in 79 percent of individuals. Typeof HL did correlate with CHD7 variant type (n = 100, p = 0.002). The most striking relationship is anincreased risk of SNHL with CHD7 haploinsufficiency due to nonsense or frameshift variants.
Conclusions: Regardless of the type or location of CHD7 variant, patients with CS are at risk for HLand should undergo temporal bone analysis as part of their initial workup. Such findings continue toexpand providers' understanding of CS and will improve the management of patients.

Objective: This study aimed to investigate the relationships between situational vertigo, smartphoneuse, sleep duration, and headaches among college students.
Methods: A cross-sectional, descriptive correlational design and survey methodology were used. A totalof approximately 55,000 students from three public and three private universities were considered for participation.A nonproportional stratified sampling method was used to target a sample size of 395 studentsper university. Data were collected using the Situational Vertigo Questionnaire (SVQ), which includesquestions about sociodemographic factors, smoking habits, electronics usage, working hours, housekeepingactivities, sleep duration, and headaches. The SVQ was translated to Arabic and validated. The statisticalanalysis included descriptive statistics, linear regression, and Pearson's correlation coefficient.
Results: This study included 1,600 participants with a mean age of 26.58 years. Significant correlationsbetween the SVQ score and older age, female sex, and smoking were found. The strongest correlationwas between the SVQ score and sleep duration (r = -0.84), indicating that a shorter sleepduration is associated with a higher incidence of situational vertigo. Smartphone use was positivelycorrelated with the SVQ score (r = 0.67) and negatively correlated with sleep duration (r = -0.74).Additionally, headaches were associated with higher SVQ scores (r = 0.24).
Conclusion: We identified significant associations between situational vertigo and smartphone use,sleep duration, and headaches among college students. Female sex, older age, and smoking werealso associated with higher susceptibility to vertigo. These findings suggest that excessive smartphoneuse may lead to sleep disturbances, which contribute to vertigo. Increased awareness of these relationshipscan inform the development of preventive measures and counseling strategies for studentson college campuses and aid health care providers in managing patients with vertigo.

Background: The AzBio Sentence-in-Noise Test was developed in 2011 and was successful in minimizingspeech-recognition ceiling effects, giving clinicians and researchers a more accurate representationof a listener's speech-in-noise recognition. Recently, the Spanish version of the AzBio corpus was developedas a sentence-recognition test that could similarly be used to reduce speech-recognition ceilingeffects in Spanish-speaking patients. The developers of the AzBio in Spanish included researchers andclinicians from the United States and Colombia.Purpose: The aim of this study was to determine whether the AzBio test batteries in English and Spanishare comparable in difficulty to proficient Spanish-English bilingual adults residing in the United States.Research Design: The study was designed as a standard group comparison.Study Sample: Participants included 20 Spanish-English bilinguals between the ages of 18 and 30 yearswith hearing thresholds no greater than 25 dB HL in both ears.Data Collection and Analysis: Participants listened to three lists of 20 sentences from the AzBioSentence-in-Noise Tests in English and in Spanish over two test sessions. Sentences were presentedat a +5 dB signal-to-noise ratio in 10-talker babble. Sentence-recognition scores were calculatedfrom total words repeated correctly out of total words presented for all three lists (60 sentencesin total) in each language condition. A language experience survey was used to quantify and explorelanguage experience in different dialects of Spanish.Results: Our results indicate that bilingual listeners scored similarly on the English and Spanish testcorpora on the group level. On an individual level, participants who spoke a Colombian Spanish dialectwere among the highest-performing listeners for the Spanish test corpus and among the lowest performinglisteners for the English corpus.Conclusions: The AzBio in Spanish is a highly valuable clinical tool for evaluating speech recognition inSpanish-speaking patients. Our results suggest that listeners who spoke a Colombian Spanish dialect,consistent with the location where the AzBio in Spanish test was developed, tend to perform better on theSpanish version of the test compared to the English version of the test. Thus, dialectical factors mayaffect sentence-recognition scores on the AzBio in Spanish corpus. Clinicians in the United States mustconsider dialect when administering this test corpus because the most common dialect in the United Statesis Mexican Spanish. Future research should evaluate the education level of listeners to determine the impactof language-specific vocabulary on sentence-recognition performance on both AzBio language corpora.

Purpose: Over-the-counter (OTC) hearing aids can potentially improve access to hearing-health careand enable individuals with mild-to-moderate hearing loss to self-manage their condition. This study com-pared the usability and performance of a range of self-fitting over-the-counter (OTC-SF) hearing aids.

Research design: This cross-sectional study evaluated six OTC-SF hearing aids.

Study sample: Forty-three adults with self-perceived mild-to-moderate hearing difficulties participatedin this study.

Data collection and analysis: Participants were randomly assigned to two of six OTC-SF hearingaids and used the manufacturer-provided instructions and smartphone applications. These hearingaids included HP Hearing PRO, Jabra Enhance Plus, Lexie B2 Powered by Bose, Lexie Lumen,Soundwave Sontro, and Sony CRE-C10. Usability was assessed based on the fitting time, hearing aidskills and knowledge (HASK), self-reported ease of the SF process, and Post-Study System UsabilityQuestionnaire (PSSUQ) results. Performance was evaluated using the judgment of sound quality (JSQ)test and speech-in-noise benefit using the digits-in-noise and quick speech-in-noise tests.

Results: Fitting time ranged from 14.4 to 27.1 min, with Lexie Lumen requiring the longest time (27.1 min;standard deviation [SD], 5.9 min) and HP Hearing PRO requiring the shortest time (14.4 min; SD = 1.9 min).The HASK scores varied, with Soundwave Sontro achieving the highest score (8.9/10) and HP Hear-ing PRO achieving the lowest score (6.8/10). Self-reported ease of SF and PSSUQ scores did notdiffer significantly between the OTC-SF hearing aids. Overall sound quality and clarity ratings signifi-cantly differed, with Lexie B2 receiving the highest rating (8.1/10 and 7.5/10) and HP Hearing PROreceiving the lowest rating (6.3/10 and 5.1/10). Speech-in-noise benefit did not differ significantlybetween devices. A thematic analysis identified seven themes of the participants' SF experiencesand six themes of the researcher's field notes. Participants generally considered OTC-SF hearing aidsuser-friendly, although issues with Bluetooth connectivity, handling and insertion, and sound quality werenoted by the researcher as common challenges.

Conclusions: Usability and performance of OTC-SF hearing aids were similar across devices in termsof useability and speech-in-noise benefits. However, the devices exhibited variations in fitting time,HASK, and sound quality, including the overall impression and clarity. These findings can support thedecisions of consumers and recommendations of health-care professionals. Further research of thelong-term usability and selection processes of OTC-SF hearing aids is necessary.