Background: Tinnitus is a prevalent condition affecting approximately 14.4 percent of the global adult population. With growing mobile phone ownership and usage globally, the utilization of smartphone applications (apps) as tinnitus interventions has garnered research and clinical interest. Despite the abundant number of commercially available tinnitus smartphone apps, a majority of them lack validation of their effectiveness.Purpose: The goal of this study was to investigate the feasibility of using a smartphone app (Oto) in tinnitus management as determined by trial acceptability, deliverability, and effectiveness.Research Design: A two-arm controlled trial design was adopted.Study Sample: Sixty-two adults with chronic tinnitus were randomized to either the Oto user group or nonuser (control) group.Intervention: The multimodal Oto smartphone app, which combines patient education, cognitive behavioral therapy, relaxation, mindfulness, and sound therapy, was used by the Oto user group for 3 months.Data Collection and Analysis: Participants completed the Tinnitus Functional Index (TFI) at baseline, 1 month, and 3 months. The Oto user group rated Oto's ease of use and their satisfaction on a 5-point Likert scale and answered open-ended questions on user experience at 3 months. One-way repeated-measures analysis of variance was performed with Bonferroni correction.Results: Overall retention rate (defined as completion of trial at 3 months) was 87 percent. Among Oto users, 16 percent had a clinically meaningful reduction (≥13 points) in the TFI score from baseline to 3 months, whereas 7 percent of nonusers met the same criterion. The Oto user group showed no significant difference in TFI scores between baseline, 1 month, and 3 months, whereas the nonuser group showed a significant increase in the overall TFI scores from baseline to 1 and 3 months (F[2, 56] = 7.78, p = 0.001). Oto users found Oto easy to use and appreciated app features such as diversely themed therapy sessions and sound library. Suggestions including adjusting the duration of therapy sessions and a more structured habituation program were also noted for improving Oto.Conclusions: Use of Oto in managing tinnitus was demonstrated to be deliverable and feasible with a high retention rate. A large-scale randomized controlled trial is currently underway to further evaluate Oto's effectiveness and app usability.
Background: Misophonia is characterized by reduced tolerance to specific sound stimuli known as triggers. The reactions can be emotional, behavioral or physiological. In response to triggers, a person with misophonia might express irritation, anger, or disgust by being verbally or physically aggressive. This ultimately affects their quality of life.Purpose: The present study aimed to determine the impact of misophonia on everyday life using the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework.Research Design: The study used a cross-sectional survey design and collected data through a qualitative resurvey search method.Study Sample: The study sample included 51 individuals with misophonia aged 18 to 30 years. The sample was recruited through the administration of the Revised Amsterdam Misophonia Scale.Data Collection and Analysis: The data were collected using two open-ended questions, the Problem Question (PQ) and the Life Effects Question (LEQ). The responses were linked to categories within ICF using a simple content analysis approach. The Wilcoxon signed-rank test was conducted to check for the significant difference between the number of responses.Results: Among 294 responses, 222 were related to PQ, and 72 were associated with LEQ. Participation in activities was most affected by misophonia, followed by impairments in body function. The most frequently affected functions were focusing attention from activity limitations and participation restrictions, followed by appropriateness of emotion from impairments of body function.Conclusions: The findings indicate that misophonia most significantly affects the domain of Activities and Participation, with subsequent impacts on Body Functions and Environmental Factors. This underscores the heterogeneous and multifaceted nature of misophonia's effects, demonstrating the effectiveness of open-ended questions in capturing the varied impacts on affected individuals.
Purpose: Current literature is conflicting and unclear when comparing perceived stress and anxiety with hearing loss. This study assesses the relationship of standard audiometric measurements to perceived stress, anxiety, and hearing impairment.Research Design: All participants were seen for a comprehensive audiological evaluation. Participants' best pure tone average (PTA) and high-frequency pure tone average (HF-PTA) were calculated from measured behavioral thresholds to pure tones of 500-8000 Hz. Word recognition scores (WRS) were obtained for each ear. Participants completed the Reduced Hearing Handicap Index Screening (RHHI-S), Perceived Stress Scale (PSS), and Generalized Anxiety Disorder - 7 item (GAD-7) questionnaires.Study Sample: Sixty-two participants seen for audiological evaluations participated in this study. The mean age of participant was 62.6 (±16.8) years.Data Collection and Analysis: Participants were grouped into age categories and analyses of variance were used to determine whether a significant difference existed among the questionnaires across the four age groups. Pearson's r correlation coefficients were used to determine a relationship between all measurements, and t tests were used to determine whether a difference in questionnaire score existed between previous hearing aid users and non-hearing aid users. Hierarchical regression analyses were applied to determine whether perceived stress or perceived hearing loss has a significant predictor in audiometric testing.Results: RHHI scores were significantly higher in those with hearing loss and the participant group containing those with hearing loss that wore hearing aids compared to those who did not. Additionally, GAD-7 scores significantly predicted PSS scores. All other comparisons were nonsignificant.Conclusions: The results from this study suggest that insights into stress and anxiety may be beneficial for counseling, but they do not seem to be related to severity of hearing impairment or speech in quiet performance.Clinical Relevance Statement: Questionnaires can provide significant insight into the perceptions of patients seeking clinical care. The findings from this study find that the RHHI-S significantly correlates with common behavioral measurements of hearing. Questionnaires that reflect on anxiety and perceived stress levels have no correlation to these measurements.
Background: Hypertrophic olivary degeneration (HOD) is a rare disorder that typically develops in the weeks to months after a structural brainstem or cerebellar lesion in the Guillain-Mollaret triangle. Clinically, patients with HOD present with palatal myoclonus and nystagmus, which are difficult to treat and rarely resolve.Purpose: The purpose of this case report is to present the results of vestibular and balance assessments of a patient with bilateral HOD before and after vestibular rehabilitation.Study Sample: 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 showed 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, optokinetic reflex, and balance function. After 4 months of VR, the patient’s eye symptoms and balance function were improved.Conclusions: The case presented in this report highlights the rare clinical manifestations of HOD after pontine hemorrhage. Vestibular rehabilitation training may be beneficial for the recovery of patients with HOD.
Background: Studies on psychoacoustic tests have demonstrated that musicians have superior perceptual abilities compared with nonmusicians in a specific, narrow age range. Whether this advantage is consistent across different age ranges is unclear. The extent to which these benefits will offset the detrimental effects of aging is unexplored.Purpose: There is a strong need to study whether music training can help reduce the impact of degenerative aging effects on perceptual tasks. Hence we investigated how music training impacts psychoacoustic abilities across a continuum of age groups.Research Design: A cross-sectional descriptive mixed design was used for the study since both between- and within-group designs were employed.Study Sample: The study included 150 subjects, 75 musicians and 75 nonmusicians, in a continuum of age range. There were 15 musicians and 15 nonmusicians in each age group (10–19.11, 20–29.11, 30–39.11, 40–49.11, and 50–59.11 years). Musicians were trained in Carnatic classical music for at least 5 years.Data Collection and Analysis: MATLAB software was used to administer the maximum likelihood procedure–based psychoacoustic tests. Thresholds were established for the pitch discrimination test (PDT), duration discrimination test (DDT), and gap detection test (GDT). The response criterion was the threshold corresponding to the psychometric function’s 79.4 percentage point.Results: All three measures followed a Gaussian distribution (p > 0.05). Results of two-way analysis of variance indicated a significant musicianship effect on all three auditory perceptual tests (p < 0.001). A significant age effect was noted in PDT and GDT (p < 0.001). Interaction effects were present on all tests (p < 0.01). The main effects of musicianship, age, and their interaction showed a “high” effect size on PDT, whereas for DDT and GDT, their effect sizes were “low to high”. Post hoc analysis indicated that age effects were evident only in nonmusicians on PDT and DDT. GDT showed an earlier age effect in nonmusicians than in musicians.Conclusions: Music training can significantly minimize the negative impacts of aging. Continued musical training improves auditory perceptual abilities to counteract the effects of aging and perhaps aids in better speech perception.
Background: We describe the falling mechanics in a 75-year-old patient diagnosed with a left vestibular schwannoma. The patient completed an experimentally designed fall paradigm before and after vestibular schwannoma treatment.Purpose: This case describes the change in neck muscle activation, vestibular function, and falling mechanics before and after left gamma stereotactic surgery.Research Design: This is a case study.Data Collection and Analysis: This patient completed two falls in three directions (backward, left, and right) before and after treatment. Motion capture and video review assessed kinematic data of falls and head impact. Neck muscle activation was collected from bilateral upper trapezius (UT) and sternocleidomastoid (SCM) muscles. Vestibular function was assessed by vestibular evoked myogenic potential (VEMP) and the video head impulse test.Results: The participant had a minor head impact before and after treatment with falls to the right. Head acceleration during falls was higher posttreatment in backward and left falls. Reduction in bilateral SCM and right UT activation but increased activation of the left UT was noted after treatment, regardless of fall direction. The left cervical VEMP that was present before treatment was absent after treatment, and the video head impulse test gain was greater than 0.8 in all directions except for the left posterior canal (0.63 before treatment), which decreased to 0.47 after treatment.Conclusions: The number or severity of head impacts did not increase despite reduced vestibular function, indicating that the participant used a different neuromuscular strategy to avoid head impact.
Objective: This study investigated the potential correlation between in vitro fertilization (IVF) and hearing impairment in twins compared to naturally conceived twins.Methods: We analyzed data from 2,416 twin infants born between 2019 and 2021, including pregnancy conditions and complications of mothers, the birth conditions of newborns, perinatal diseases, initial hearing screening results, and subsequent follow-up conditions.Results: Our findings reveal that the incidence of hearing impairment in IVF-conceived twins is comparable to that in naturally conceived twins. Significant differences in low birth weight, preterm birth, respiratory distress syndrome, and hyperbilirubinemia were observed between infants who passed and those referred for hearing screening (p < 0.05). The IVF group exhibited a lower incidence of low birth weight (p < 0.05) and older maternal age (p < 0.05) and had higher rates of placental abnormalities and placental abruption (p < 0.05). Notably, these distinctions did not translate into a significant impact on hearing impairment. Regardless of the method of conception, the following key factors contributing to hearing impairment in twins were identified: low birth weight, preterm birth, respiratory distress syndrome, and hyperbilirubinemia.Conclusions: IVF technology does not exert specific effects on hearing impairment in twins; perinatal complications are the primary influencing factors.
Background: Hearing loss is the most common sensory disorder in children, affecting 0.1 percent of newborns. The auditory brainstem response (ABR) test is the gold standard diagnostic test for infants who are unable to participate in behavioral testing. ABR is preferably performed under natural sleep (NS-ABR) to avoid risks associated with general anesthesia and sedation. However, if the infant wakes up during an NS-ABR, the test must be stopped and may need to be repeated later. Delays in diagnosis can place the child at higher risk for delays in cognitive and educational development.Purpose: We sought to understand factors that contribute to successful NS-ABR.Research Design: This was an exploratory mixed methods study to understand the barriers in obtaining an NS-ABR that is clinically sufficient for management.Study Sample: We performed a retrospective review of 0- to 12-month-old children who underwent NS-ABR.Data Collection and Analysis: For the quantitative approach, we studied 86 consecutive infants of 0–12 months of age who underwent NS-ABR. For qualitative analysis, semistructured interviews and focus groups with audiologists were performed and analyzed using a thematic analysis approach.Results: Among the cohort of 86 infants, 164 NS-ABRs were performed. Sixty-three (73 percent) patients obtained a successful NS-ABR; only 65 (40 percent) of NS-ABRs were successful. The most common reasons for unsuccessful NS-ABR were poor sleep quality (n = 60/99, 61 percent), needing to “expand and confirm findings” (n = 26, 26 percent), and lack of or nonadherence to patient instructions (n = 27, 27 percent). Previous NS-ABR attempts and auditory steady-state response (ASSR) were significantly associated with successful NS-ABR (odds ratio [OR] = 1.46, 90 percent confidence interval [CI] = 1.13–2.05; OR = 4.65, 90 percent CI = 1.70–12.73, respectively). We identified four themes that impact success: inadequate logistical support for providers, inadequate emotional support for providers, providers juggling multiple tasks, and inadequate system scheduling flexibility. We triangulated these results to model interactions between factors that contribute to successful NS-ABR.Conclusions: NS-ABR is a diagnostic tool that can decrease patient exposure to sedation and anesthesia. This study suggests that individual, caregiver, provider, and systemic factors impact the success of NS-ABRs, especially for underserved populations. Multilevel interventions to improve success rates of NS-ABR would help decrease time from screening to diagnosis.
Background: Exposure to noise or loud sound damages the cochlea and can result in hearing loss, which has been well-documented. Research over the years has shown that individuals exposed to noise for a short or extended period may develop vestibular problems. The otolith organs are found to be more susceptible to noise exposure or acoustic trauma than the semicircular canals (SCC). Nonetheless, little is known about the functioning of all three SCC in individuals exposed to noise. A technologically advanced, noninvasive, simple, and fast tool, the video head impulse test (vHIT) helps in evaluating the functioning of all six SCC in three planes.Purpose of the Study: We assessed the functioning of SCC using the vHIT paradigm in individuals with and without noise exposure.Research Design: The study used a quasi-experimental, between-groups design.Study Sample: The study included15 individuals with occupational noise exposure for at least 5 years (clinical group) and 15 individuals without noise exposure (control group) aged 30 to 55 years.Data Collection and Analysis: The vHIT was administered using the head impulse paradigm to assess the vestibular-ocular reflex (VOR) gain of the six SCC in all three planes.Results: The study showed a significantly reduced VOR gain in lateral SCC among individuals with noise exposure in comparison to their healthy counterparts. In addition, refixation saccades (overt and covert) were noticed in 46 percent of individuals with noise exposure, whereas none of the participants exhibited refixation saccades in the control group.Conclusions: Although the semicircular canal is reported to be less susceptible to the effects of noise, the findings of reduced VOR gain and the presence of refixation saccades in the clinical group reveal that the semicircular functioning could be altered in individuals exposed to noise. Therefore, individuals with noise-induced hearing loss should undergo peripheral vestibular assessment, including semicircular canal functioning, for better rehabilitation. vHIT showed promising findings in assessing SCC functioning among individuals with noise exposure.
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