Journal of the American Academy of Audiology最新文献

Background:  Cervical vestibular-evoked myogenic potentials (cVEMPs) are predominantly ipsilateral, myogenic responses originating from saccular activation. Some individuals have contralateral-crossed cVEMP responses with monaural air-conducted stimulation (ACS) which can contaminate cVEMP responses with bilateral stimulation. While the origin of the contralateral-crossed response is under debate, its presence has implications for cVEMP testing with midline bone conduction vibration (BCV).

Purpose:  The purpose of this study was to determine the origin of the contralateral-crossed cVEMP response. It was hypothesized that the crossed response is due to electrode contamination and would disappear with a modified electrode montage.

Research design:  This is a cross-sectional research study.

Study sample:  Fifteen healthy participants (30 ears; mean age: 27.4 19-39; 10 females).

Data collection and analysis:  Participants completed cVEMP testing using three stimulation methods (monoaural ACS, binaural ACS, and midline BCV) and two electrode montages (sternum reference and Fp reference).

Results:  In the monoaural ACS with sternum reference condition, 53.3% ears had contralateral-crossed cVEMP responses that were in-phase with the ipsilateral response for all but three ears. Whereas in the monoaural ACS with Fp reference condition, 3% had a contralateral-crossed cVEMP response. ACS and BCV cVEMP corrected amplitudes were significantly larger in the sternum reference conditions, which is attributed to artificial enhancement from the in-phase contralateral-crossed responses.

Conclusions:  The significant reduction of contralateral-crossed responses in the Fp reference condition suggests that the contralateral-crossed cVEMP response is due to reference electrode contamination and may be a more appropriate reference placement when completing cVEMPs with midline BCV.

Background:  Clinicians are increasingly interested in self-reported hearing-specific quality of life (HQoL) for cochlear implant (CI) recipients, including pediatric CI recipients.

Purpose:  (1) To compare HQoL of adolescent CI recipients to those of peers with typical hearing (TH); (2) to examine, longitudinally, HQoL for a set of CI recipients; and (3) to determine the effects of child, demographic, audiological, speech perception, and language variables on adolescent HQoL.

Research design:  Hearing Environments and Reflections on Quality of Life (HEARQL) questionnaires were completed by children with CIs at elementary (HEARQL-26) and adolescent (HEARQL-28) ages.

Study sample:  Eighty CI recipients and 21 children with TH.

Data collection and analysis:  HEARQL-28 scores for the CI and TH groups were compared using nonparametric tests. Regression models were used to examine longitudinal results and to explore predictor variables for adolescent CI participants' HEARQL-28 scores.

Results:  HEARQL-28 scores for CI participants were lower than those of peers with TH. For both CI and TH adolescents, the HEARQL subscale with the lowest score is "Hearing Situations." CI participants' HEARQL scores at elementary age were not significantly correlated with scores at adolescence. Over 70% of unexplained variance remains even after inclusion of variables with established contributions to traditional CI benefit.

Conclusions:  Self-reported HEARQL scores are largely unexplained for pediatric CI recipients; multidisciplinary explorations of other sources of variance, such as social, emotional, and psychosocial factors, should be pursued.

Objective:  The objectives of the study were to (i) evaluate the effectiveness of wideband absorbance (WBA) at ambient pressure (WBA_amb), tympanic peak pressure (WBA_TPP), and 0 daPa (WBA₀) to identify conductive hearing loss (CHL) in infants and (ii) compare the sensitivity and specificity of the three WBA tests with that of high-frequency tympanometry (HFT) and transient-evoked otoacoustic emissions (TEOAE).

Method:  A total of 31 ears with hearing thresholds no greater than 20 dB HL (reference group from 20 infants [mean age: 3.1 weeks]) and 47 ears with CHL from 31 infants (mean age: 3.4 weeks) were included in the study. Hearing threshold was determined using air-conduction tone-burst auditory brainstem response (TB-ABR) test, whereas CHL was determined using both air- and bone-conduction TB-ABR tests. HFT with a 1000-Hz probe tone, TEOAE, and WBA tests were conducted on all participants.

Results:  WBA_amb, WBA_TPP, and WBA₀ of the CHL group were significantly lower than that of the reference group across a wide frequency range. Area under the receiver operating characteristic (AROC) curve for detecting CHL varied from 0.51 to 0.9 depending on the frequency. The highest AROC was obtained at 1.25 kHz for WBA_amb (0.79), at 1.5 kHz for WBA_TPP (0.9) and at 1 kHz for WBA₀ (0.80). The sensitivity and specificity were 0.98 and 0.45, respectively for HFT, and 1.0 and 0.6, respectively for TEOAE. In comparison, the WBA test had slightly lower sensitivity but higher specificity than the HFT and TEOAE tests.

Conclusion:  WBA_TPP at 1.5 kHz can identify CHL in infants as good as, if not more accurately than, WBA_amb or WBA_0. WBA_TPP test had good balance of high sensitivity and specificity compared with HFT and TEOAE. The three WBA tests are useful tools for identifying CHL in infants under 6 weeks of age.

Purpose:  The purpose of this study is to examine whether the gap detection thresholds (GDT) obtained are similar between an adaptive and nonadaptive procedure in children and adults.

Study design:  Standard group comparison.

Study sample:  Eighteen typically developing children and 20 young adults with hearing thresholds of 25 dB HL or lower participated in this study.

Methods:  Forced choice (FC) adaptive GDTs were obtained using psychoacoustic software, and nonadaptive GDTs were obtained using a clinically available gap in noise (GIN) test.

Results:  Both children and adults showed significantly lower GDTs for the FC adaptive procedure when compared with thresholds obtained using the nonadaptive GIN test. GDTs were less variable for FC adaptive procedure when compared with the nonadaptive procedure.

Conclusion:  Lower and less variable GDTs can be obtained from children and adults using an FC adaptive procedure.

Objective:  Many hearing aid manufacturers have developed application programs that allow audiologists to fine-tune or adjust their patients' hearing aids remotely. This study aims to explore audiologists' experiences in using the remote hearing aid adjustment in Malaysia.

Method:  This is a qualitative research design where focus group discussions among audiologists were held. The interview data were analyzed using reflexive thematic analysis to identify patterns and reconstruct meaning.

Study sample:  Ten audiologists with at least 1 year of work experience in providing remote hearing aid adjustment services to adult patients were recruited.

Results:  Even though there has been an increased utilization of remote fine-tuning among audiologists in Malaysia due to the coronavirus disease 2019 pandemic, its use among audiologists remains limited at present. Five thematic areas were identified: "Adoption of Practice," "Challenges and Limitations," "Benefits and Opportunities," "Satisfaction," and "Recommendations for Improvement." The TedAP challenges (T-technical challenges: e-ease of use, d-digital competency; A-abuse of system, and P-physical examinations) have been identified under the "Challenges and Limitations" theme. Suggestions for improvement include integrating the applications and video calls on a common platform, assigning a "standby" trained audiologist, and incorporating remote fine-tuning into audiology education.

Conclusion:  Challenges and limitations associated with the provision of tele-audiology have been documented based on the views and experiences of audiologists in Malaysia. Despite the barriers, audiologists acknowledged the benefits associated with remote systems and recommendations were provided to improve the services. The results of this study could contribute to the increase in the use of tele-audiology in Malaysia. This would be instrumental in developing further the audiology profession in terms of the adoption of tele-audiology and telehealth in Malaysia.

Background Hypertrophic olivary degeneration (HOD) is a rare disorder that typically develops in the weeks to months following a structural brainstem or cerebellar lesion in the Guillain-Mollaret triangle (GMT). Clinically, patients with HOD present with palatal myoclonus and nystagmus, which are difficult to treat and rarely resolve. Purpose The purpose of this case is to present the results of vestibular and balance assessments of a patient with bilateral HOD before and after vestibular rehabilitation. Methods This case report describes a 43-year-old trucker who presented with dizziness, blurred vision, and balance problems for more than 10 months, accompanied by new-onset tremors and ataxia for more than 6 months. The patient's characteristic clinical manifestations were palatal myoclonus and nystagmus. Magnetic resonance imaging (MRI) revealed bilateral HOD after an acute pontine hemorrhage. Comprehensive vestibular and balance assessments were performed. Results Vestibular and balance assessments demonstrated nystagmus, impaired vestibulo-ocular reflex (VOR), optokinetic reflex (OKR), and balance function. Following 4 months of vestibular rehabilitation, the patient's eye symptoms and balance function were improved. Conclusions The case presented here highlights the rare clinical manifestations of HOD after pontine hemorrhage. Vestibular rehabilitation training may be beneficial for the recovery of patients with HOD.

Background:  Children with hearing loss (HL) have difficulty in performing the complex functions of language, especially in noisy environments. Cognitive processes such as working memory and short-term memory are effective on individual differences in language skills in children with HL.

Purpose:  The present study aimed to evaluate the vocabulary and syntax skills in language development areas and working memory of children with HL and to compare these results with those of their peers with normal hearing (NH).

Research design:  In this study, a causal-comparative research model was used to measure vocabulary and syntax skills, which are among the working memory and language development skills of children with NH and those with HL.

Study sample:  A total of 88 children, 44 children with HL aged 60 to 107 (months) and age- and gender-matched 44 children with NH, were included in the study.

Intervention:  Evaluation was made in two sessions of 20 minutes for each participant.

Data collection and analysis:  The language development and working memory of 44 children with HL and 44 children with NH were evaluated and the two groups were compared with each other. The Working Memory Scale (WMS) was used to evaluate the working memory of the participants and three subtests (vocabulary, sentence repetition, and sentence comprehension) of the Test of Language Development-Primary Fourth Edition: Turkish Version (TOLD-P:4) were used to evaluate language development. SPSS 23.0 program was used in the analysis of the data.

Results:  Children with HL obtained lower scores than their peers with NH in all three TOLD-P subtests. Children with HL obtained significantly lower scores in WMS verbal memory and general WMS scores compared with NH children. A positive correlation was found between WMS Verbal Memory Scores and TOLD-P sentence comprehension and sentence repetition scores. WMS Visual Memory Scores predicted the group with HL and all TOLD-P scores and Verbal Memory Scores predicted the group with NH.

Conclusion:  Working memory skills are the predictor of language comprehension, reasoning, learning, literacy skills, and language development. Thus, including working memory skills as well as language skills in the education programs of children with HL contributes to the children's development.

Background:  Despite significant advances in the field of cochlear implants (CIs), there is no widely accepted criterion for when to counsel on bilateral CIs in adults. This is partly due to conflicting findings on the advantages of bilateral CIs versus bimodal hearing (i.e., CI with a contralateral hearing aid). Because of this, clinicians rely on a poorly defined combination of clinical measures and patient discussion to evaluate a patient's listening needs and preferences. Patients' needs and preferences are often used to guide recommendations on whether bilateral CIs or bimodal hearing is best for that individual, suggesting that an in-depth comparison of each group's self-reported outcomes is warranted.

Purpose:  Given the limited number of studies directly comparing quality of life (QoL) in bimodal and bilateral patients, the current study conducted a preliminary comparison of self-reported outcomes to better understand patient-reported benefits of each listening configuration.

Research design:  This was a between-subjects comparison.

Study sample:  Fifteen bimodal and nine bilateral adult CI users made the study sample.

Data collection and analysis:  Participants completed the Cochlear Implant Quality of Life (CIQOL) Profile 35. For group comparison purposes, monosyllabic word recognition and nonverbal intelligence were measured. Independent samples t-tests with Holm-Bonferroni corrections were used to compare bimodal and bilateral patients across domains of the CIQOL.

Results:  Bilateral CI users self-reported better environmental, emotional, social, and global QoL when compared to bimodal users. The groups did not differ on age, nonverbal intelligence, speech recognition abilities, and duration of hearing loss; however, bimodal users had less experience listening with their CI than the bilateral CI users.

Conclusion:  Bilateral CI users showed widespread advantages in QoL when compared to bimodal users. Bilateral CI users self-reported significantly better environmental QoL which conflicts with previous in-lab and self-report results suggesting a bimodal advantage. Additionally, due to a lack of current literature, it is unclear why a bilateral advantage is observed for emotional and social QoL. Results of the current study not only provide additional support on the benefits of bilateral implantation but also stress the need to further explore the self-reported benefits of each listening configuration.