Journal of the American Academy of Audiology最新文献

Background: Simultaneous Multifrequency (SiMFy) is a time-saving and reliable stimulus to determine the frequency tuning of ocular vestibular-evoked myogenic potential (oVEMP); however, the absence of 4000 Hz in SiMFy potentially makes it a less potent tool for the diagnosis of Superior semicircular canal dehiscence, a pathology with an ever-increasing prevalence. Further, SiMFy was validated using only the infra-orbital (IO) electrode montage. However, the recordings obtained using the IO montage might be susceptible to reference contamination introduced by a small separation between the recording electrodes, and also susceptible to reflex impurity due to the spatially displaced reference electrode from the inferior oblique muscle (IOM), rendering it vulnerable to picking up responses from other muscles. Nonetheless, little is known about the similarities/differences between the SiMFy-induced oVEMPs using alternate montages [belly-tendon (BT), chin-reference (CR), and sternum-reference (SR)] and the non-simultaneous multifrequency oVEMPs (NSM-oVEMPs) using the IO montage.

Purpose of the study: To develop a modified SiMFy stimulus and investigate its effects on frequency tuning of oVEMP using various electrode montages.

Research design: Within-subject experimental design.

Study sample: Thirty-three healthy adults aged 20-30 years.

Data collection and analysis: Tone bursts of octave and mid-octave frequencies from 250 Hz to 4000 Hz were generated and concatenated to create the modified SiMFy stimulus. All participants underwent non-simultaneous multifrequency oVEMPs and modified SiMFy oVEMPs using BT, CR, SR, and IO montages simultaneously. The response rate, peak-to-peak amplitude, and frequency tuning were compared between NSM-oVEMP and modified SiMFy oVEMP and also between the electrode montages.

Results: BT montage recorded the largest amplitude among the montages in non-simultaneous multifrequency stimulation and modified SiMFy stimulation. Although the response rates were comparable, the modified SiMFy produced significantly lower oVEMP amplitudes than the non-simultaneous multifrequency stimulation within each electrode montage (p < 0.05). A moderate-to-strong agreement on frequency tuning existed between the non-simultaneous multifrequency stimuli and modified SiMFy stimulus for all the montages, except for the SR montage.

Conclusions: Although the modified SiMFy produces smaller amplitude oVEMPs than the non-simultaneous multifrequency stimulation for the respective montages, its use in combination with the BT montage yields higher response rates and larger peak-to-peak amplitudes than the non-simultaneous multifrequency recording using IO montage.

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: We describe a 42-year-old patient with reported "shaking" vision referred due to concerns of possible vestibular system dysfunction. The patient has known history of Usher syndrome type I, bilateral cochlear implants, and severe vision impairment.

Purpose: This case describes an unusual nystagmus previously only reported in individuals with central demyelinating disorders, significant light deprivation, or in congenital / early-onset visual pathway impairment.

Research design: Case study.

Data collection and analysis: Retrospective chart review of vestibular function.

Results: Vestibular function was likely absent in this case. There was no evidence of vestibular (jerk) nystagmus for sinusoidal harmonic acceleration stimuli or repeatable responses for cervical vestibular evoked myogenic potentials. Significant pendular low amplitude high frequency oscillations of approximately 6 Hz were present for horizontal and vertical tracings throughout testing.

Conclusions: Nystagmus may not always be associated with vestibular system impairment. In this case, the patient's reported "shaking" vision was attributed to pendular low amplitude high frequency nystagmus and hypothesized to relate to long-standing significant vision impairment. This presentation is unusual in adults and has historically been associated with individuals with significant central pathology or in those with long duration light deprivation.

Background: Recently, we developed a hearing-related lifestyle questionnaire (HEARLI-Q) which asks respondents to rate their hearing aid (HA) satisfaction in 23 everyday listening situations. It is unknown how HA satisfaction on the retrospective HEARLI-Q scale compares to HA satisfaction measured on the same scale implemented in Ecological Momentary Assessments (EMA).

Purpose: To learn how retrospective (HEARLI-Q) and in-situ (EMA) assessments can complement each other.

Research design: An observational study.

Study sample: Twenty-one experienced HA users.

Data collection and analysis: The participants first filled out the HEARLI-Q questionnaire, followed by a one-week EMA trial using their own hearing aids. HA satisfaction ratings were compared between the two questionnaires and the underlying drivers of discrepancies in HA satisfaction ratings were evaluated.

Results: HA satisfaction scores were significantly higher in EMA for speech communication with one or several people. Hearing difficulty in these situations was rated higher in HEARLI-Q than in EMA, but occurrence of those difficult listening situations was also rated to be lower. When comparing only the situations that occur on daily or weekly basis, the two questionnaires had similar HA satisfaction ratings.

Conclusions: Lower occurrence of difficult listening situations seems to be the key driver of discrepancies in HA satisfaction ratings between EMA and HEARLI-Q. The advantage of EMA is that it provides insight into an individual's day-to-day life and is not prone to memory bias. HEARLI-Q, on the other hand, can capture situations which occur infrequently or are inconvenient to report in the moment. Administering HEARLI-Q and EMA in combination could give a more holistic view of HA satisfaction.

Vestibular neuritis is one of the most common reasons that someone may experience an episode of acute spontaneous vertigo, with the majority cases impacting only one ear. Cases of bilateral vestibular neuritis are rare and are thought to account for less than 10% of all cases of vestibular neuritis. 18,1,9,15,12 Skull vibration testing is an efficient means to screen for asymmetry in vestibular function but is still in its infancy in clinical use. The ideal assessment methods and the typical patterns of skull vibration induced nystagmus are relatively well understood, however, the presentation of skull vibration induced nystagmus in atypical labyrinthine pathology is less clear. Skull vibration induces a horizontal nystagmus that beats toward the healthy labyrinth in most instances of significant labyrinthine asymmetry. We pose a case report of a patient that's symptomology and clinical test findings are most consistent with bilateral sequential superior branch vestibular neuritis with an up beating skull vibration induced nystagmus.

Background: The concept of occupational self-esteem is the value judgment developed towards the chosen profession, while job satisfaction includes positive emotional attitudes towards the job. Professional self-esteem and job satisfaction levels of audiologists are a matter of curiosity.

Purpose: To determine the effect of the workplace types of audiologists in Turkey on their professional self-esteem and job satisfaction levels.

Study sample: The study included 307 audiologists working in various types of workplace. Participation in the study was voluntary.

Data collection: A Personal Information Form, Arıcak's Occupational Self-Esteem Scale, and the Minnesota Job Satisfaction Scale were administered in all individuals via Google forms and the scale scores were compared according to the workplace types.

Results: A statistically significant relationship was found between professional self-esteem and job satisfaction, age, satisfaction with workplace, satisfaction with working conditions, effect of workplace on professional development, and income satisfaction (p<0.05). However, no statistically significant relationship was found between professional self-esteem and professional tenure and tenure in the current organization (p>0.05). There was a strong positive statistically significant relationship between job satisfaction and professional self-esteem of audiologists working at state hospitals, hearing aid centers, university hospitals, rehabilitation centers, and cochlear implant centers and academics (p<0.05).

Conclusions: According to the present results, although the professional self-esteem of audiologists in Turkey showed a small difference according to the type of workplace, their mean score was high. This shows that audiologists enjoy their profession. Job satisfaction levels were lower especially in rehabilitation centers and private hospitals. We think that improving the working conditions of audiologists in private institutions will be effective in improving the services provided to patients by leading to better job satisfaction.

Background: Nonlinear frequency compression (NFC) is a signal processing technique designed to lower high frequency inaudible sounds for a listener to a lower frequency that is audible. Because the maximum frequency that is audible to a listener with hearing loss will vary with the input speech level, the input level used to set nonlinear frequency compression could impact speech recognition.

Purpose: The purpose of this study was to determine the influence of the input level used to set nonlinear frequency compression on nonsense syllable recognition.

Research design: Nonsense syllable recognition was measured for three NFC fitting condition (i.e., with nonlinear frequency compression set based on speech input levels of 50-, 60-, and 70-dB SPL, respectively), as well as without nonlinear frequency compression (restricted bandwidth condition).

Study sample: Twenty-three adults (ages 42-80 years old) with hearing loss.

Data collection and analysis: Data were collected, monaurally, using a hearing aid simulator. The start frequency and frequency compression ratios were set based on the SoundRecover Fitting Assistant. Speech stimuli were 657 consonant-vowel-consonant nonwords presented at 50, 60, and 70 dB SPL and mixed with steady noise (6 dB SNR) and scored based on entire word, initial consonant, vowel, and final consonant. Linear mixed effects examined the effects of NFC fitting condition , presentation level, and scoring method on percent correct recognition. Additional predictor variables of start frequency and frequency-compression ratio were examined.

Results: Nonsense syllable recognition increased as presentation level increased. Nonsense syllable recognition for all presentation levels was highest when nonlinear frequency compression was set based on the 70 dB SPL input level and decreased significantly when set based on the 60- and 50-dB SPL inputs. Relative to consonant recognition, there was a greater reduction in vowel recognition. Nonsense syllable recognition between NFC fitting conditions improved with increases in the start frequency, where higher start frequencies led to better nonsense word recognition.

Conclusions: Nonsense syllable recognition was highest when setting nonlinear frequency compression based on a 70 dB SPL presentation level and suggest that a high presentation level should be used to determine nonlinear frequency compression parameters for an individual patient.

Background: We previously reported the results of exploratory factor analysis (EFA) of the Hyperacusis Impact Questionnaire (HIQ), the Sound Sensitivity Symptoms Questionnaire (SSSD) and the Screening for Anxiety and Depression in Tinnitus (SAD-T). Confirmatory Factor Analysis (CFA) is necessary to confirm the latent constructs determined using EFA. CFA should use different samples but with similar characteristics to those used for EFA.

Purpose: The aim was to use CFA to confirm latent constructs derived using EFA of the HIQ, SSSQ and SAD-T. We further evaluated the psychometric properties of parent versions of these questionnaires (indicated by -P), which are intended for use with children.

Research design: This was a retrospective cross-sectional study.

Study sample: Data for 323 consecutive adults and 49 children who attended a Tinnitus and Hyperacusis Therapy Clinic in the UK within a six-month period were included.

Data collection and analysis: Data were collected retrospectively from the records of patients held at the audiology department. CFA with the weighted least-squares mean and variance-adjusted estimator was applied to assess the previously proposed factor structures of the HIQ, SSSQ and SAD-T. The internal consistency of the scales was assessed via Cronbach's alpha (α). The items of the HIQ, SSSQ and SAD-T were tested for measurement invariance regarding age and gender using the multiple indicator multiple cause (MIMIC) model.

Results: All questionnaires showed good to excellent internal consistency, with α = 0.93 for the HIQ, 0.87 for the SSSQ, and 0.91 for the SAD-T. The parent versions showed acceptable to good internal consistency, with α = 0.88 for the HIQ-P, 0.71 for the SSSQ-P, and 0.86 for the SAD-T-P. CFA showed that the HIQ, SSSQ, and SAD-T were all one-factor questionnaires and the factors generally were similar to those obtained for the EFA. The MIMIC model showed that all three questionnaires can be considered as measurement invariant, with scores similar across genders and ages.

Conclusions: The HIQ, SSSQ and SAD-T are internally consistent one-factor questionnaires that can be used in clinical and research settings to assess the impact of hyperacusis, the severity of sound sensitivity symptoms, and to screen for anxiety and depression symptoms. Future studies should further explore the psychometric properties of the parent versions of the HIQ and SSSQ and SAD-T.