Journal of the American Academy of Audiology最新文献

Background:  The video head impulse test measures high-frequency vestibulo-ocular function of all six semicircular canals. Isolated semicircular canal dysfunction has been correlated with several peripheral and central vestibular etiologies. Selective bilateral posterior canal dysfunction is a trend seen in the clinical setting but less commonly reported in the medical literature.

Purpose:  The purpose of this work is to explore the clinical profile of bilateral posterior canal dysfunction along with other presenting factors such as hearing loss, increased age, and associated nystagmus patterns.

Method:  A case series of three patients (age range: 67-74 years) is presented to illustrate the similarities and clinical associations between vestibular and balance history, medical history, and vestibular test results.

Results:  All three patient cases presented with below reference range posterior semicircular canal function on video head impulse testing. Two patients also presented with down-beating nystagmus, and two endorsed subjective hearing loss while the third presented with presbycusis.

Conclusion:  Selective bilateral posterior canal dysfunction in association with advanced age, presbycusis, and signs of down-beating nystagmus may be associated with vestibulocochlear degenerative processes. Yet, central disorders, technical and patient factors may present clinical challenges to elucidate the cause.

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 NFC could impact speech recognition.

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

Research design:  Nonsense syllable recognition was measured for three NFC fitting conditions-with NFC set based on speech input levels of 50, 60, and 70 dB SPL, respectively, as well as without NFC (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 signal-to-noise ratio) 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 NFC 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.

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

Background:  The masseter vestibular-evoked myogenic potential (mVEMP) test evaluates the vestibulomasseteric reflex neural pathway between the sound-stimulated saccule hair cells and the motor neurons of the trigeminal nerve.

Purpose:  This study aims to investigate the contribution of mVEMP to the conclusive diagnosis of recurrent vestibulopathy patients that were diagnosed with Possible Meniere's disease.

Methods:  The study includes 20 healthy individuals aged 18 to 40 years and 20 patients that were diagnosed with Possible Meniere's disease according to the American Academy of Otorhinolaryngology and Head and Neck Surgery (AAO-HNS, 1995) Guidelines for the Definition of Meniere's Disease. In addition to the AAO-HNS, 1995 criteria, the presence of aural signs on the affected side was questioned according to the Meniere's criteria updated in 2015. mVEMP records were obtained by using surface electrodes placed on masseter muscles. Latency and amplitude values and asymmetry ratios of mVEMP waves were used for statistical analysis.

Results:  Asymmetry ratios were 15.9 ± 9.7% for the control group and 60.61 ± 45.52 for the experimental group; this difference was statistically significant (p < 0.05). The absolute latency and amplitude results were not statistically different between groups (p > 0.05).

Conclusion:  As Murofushi et al. (2001) stated in the literature, cervical vestibular-evoked myogenic potential (VEMP)/ocular VEMP latencies were not affected in peripheral pathologies, and in our study, no difference was observed between the groups in mVEMP latencies. The findings of our study showed that asymmetry ratio and absence of waves should be used in the clinical evaluation of Possible Meniere's disease. We conclude that mVEMP can be used to determine the lateralization of vestibular disorders and to support the presence of a vestibular pathology. mVEMP can contribute to the vestibular test battery.

Background:  Falls are a significant health care concern for older adults in the United States. Audiologists are health care providers who are experts in hearing and vestibular dysfunctions, two areas known to be risk factors for falls. It is not known whether audiology patients consider audiology services to be related to falls or whether they consider audiologists to be a viable resource related to fall-related health care.

Purpose:  The purpose of this study was to investigate whether audiology patients consider (1) hearing, dizziness, and balance difficulties as risk factors for falls, and (2) audiologists as health care providers who can address fall risk, assessment, and prevention.

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

Study sample:  In total, 78 community-dwelling audiology patients aged 60 years or older were included in the study.

Intervention:  Not applicable DATA COLLECTION AND ANALYSIS:  To reach a broad group of participants, online surveys (Qualtrics) and paper-and-pencil surveys (at the university clinic) were used. The analysis included descriptive statistics and independent-samples t-tests.

Results:  Nearly half of participants (48.7%) fell within the preceding year, and almost three-quarters (72.4%) felt falls were an important health care concern for them. Fewer than half (43.4%) considered hearing loss to be a fall risk factor, compared to dizziness (92.2%) and balance problems (97.3%). Slightly over half (53.3%) agreed that audiologists can address falls, fall risk, and prevention. However, only 39.5% would discuss falls with their audiologist, compared to 57.9% for dizziness and balance concerns and 90.5% for hearing concerns. No significant differences were found between participants who reported a recent fall and those who did not.

Conclusions:  Targeted patient education regarding the audiology scope of practice as it pertains to fall risk and prevention may be warranted, particularly if hearing loss is a modifiable fall risk factor which can be addressed through seeking audiologic services.

Background:  Coronavirus disease 2019 (COVID-19) and its effects on hearing performance have been an interesting topic for researchers recently.

Purpose:  The objective of this study was to assess the audiological profile of people affected by COVID-19 and also to compare them with a control group who has never had COVID-19.

Research design:  An experimental study.

Study sample:  The study group consisted of 54 participants, aged 18 to 60, who were diagnosed with COVID-19 by polymerase chain reaction and recovered at least 2 months prior to audiological assessment. The control group consisted of 60 subjects in the same age range who did not have a history of COVID-19 or hearing loss.

Data collection and analysis:  Post-COVID audiological data were compared. The pre-COVID-19 audiological data of 43 subjects in the study group were also compared with their post-COVID-19 data. All participants were evaluated with pure tone audiometry, acoustic immittancemetry, speech audiometry, and high-frequency audiometry.

Results:  Pure tone hearing thresholds, speech recognition and discrimination scores, and high-frequency hearing thresholds were all statistically different between the study and control groups (p < 0.05). There were statistically significant differences between the study group's pure tone hearing thresholds before and after COVID-19 (p < 0.05).

Conclusion:  COVID-19 can adversely affect hearing performance. Further studies including auditory brainstem response, otoacoustic emissions, and similar cross-check tests are needed to reveal further effects of COVID-19 on hearing.

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 United Kingdom within a 6-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 α (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.

Conclusion: 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, SSSQ, and SAD-T.

Background:  The concept of occupational self-esteem is the value judgment developed toward the chosen profession, whereas job satisfaction includes positive emotional attitudes toward 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 Türkiye on their professional self-esteem and job satisfaction levels.

Study sample:  The study included 307 audiologists working in various types of workplaces. 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 to 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).

Conclusion:  According to the present results, although the professional self-esteem of audiologists in Türkiye 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:  Hidden hearing loss (HHL) is a newly described condition that has been associated with hearing thresholds within normal limits and poorer speech-in-noise (SIN) performance. Furthermore, HHL has been associated with an elevated or absent middle ear muscle reflex (MEMR). One of the leading factors causing HHL is exposure to noise, specifically in patients who experience temporary threshold shift. This study investigated the SIN performance and MEMR in individuals at risk for noise exposure. Additionally, this study investigated the auditory nerve response measured to different stimulation rates in order to evaluate the auditory nerve adaptation and potentially identify neural loss in individuals at risk for noise exposure.

Research design:  Twenty-one young-adult participants (11 low-risk and 10 high-risk) were recruited to participate in the study. Participants were divided into a low-risk and high-risk group based on their noise exposure history and if they have experienced any signs of temporary threshold shift following noise exposure. SIN testing, distortion product otoacoustic emissions (DPOAEs), MEMR, hearing thresholds, and electrocochleography (ECochG) were measured. Experimental protocol included measuring MEMR, word recognition scores in quiet and in noise (0 dB signal-to-noise ratio), and ECochG recordings at three rates (9.1, 37.1, and 71.1 clicks/seconds).

Data analysis:  Descriptive statistics are provided for the different variables. Contingency tables were used to investigate the frequency of measuring normal MEMR between both groups. We also investigated the audiometric threshold, DPOAEs amplitude, and SIN results between groups using independent samples t-tests. Lastly, we investigated the effect of stimulation rate on the summating potential (SP) and action potential (AP) between groups using repeated measures analysis of variance with mixed effects.

Results:  No significant differences in hearing thresholds or DPOAEs amplitude at any tested frequency between both groups. Significantly larger number of participants in the high-risk group have abnormal MEMR compared with the low-risk group. Significantly poorer performance on SIN, smaller AP amplitude, and greater SP/AP amplitude ratio in the high-risk group. Furthermore, the AP amplitude adapted differently for the high-risk group with increasing stimulation rate compared with the low-risk group.

Conclusions:  The results of this study show that HHL is associated with poorer SIN performance and abnormal MEMR. Additionally, the significant reduction in AP amplitude and the degree of AP amplitude adaptation with change in stimulus rate might indicate loss of neural output in individuals with a history of noise exposure.