Journal of the American Academy of Audiology最新文献

Purpose: The aim of this study was to examine the efficacy of auditory training to improve cognitive function 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 typically older 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 controlled trials. 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 is statistically 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 working memory 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 = 96 percent) and working memory domain (I² = 98 percent) have high heterogeneity. Conclusions: The overall impact of auditory training on overall cognition and executive function seems to 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-quality evidence is needed.

Objective: This study aimed to investigate the relationships between situational vertigo, smartphone use, sleep duration, and headaches among college students. Methods: A cross-sectional, descriptive correlational design and survey methodology were used. A total of 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 students per university. Data were collected using the Situational Vertigo Questionnaire (SVQ), which includes questions about sociodemographic factors, smoking habits, electronics usage, working hours, housekeeping activities, sleep duration, and headaches. The SVQ was translated to Arabic and validated. The statistical analysis 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 correlations between the SVQ score and older age, female sex, and smoking were found. The strongest correlation was between the SVQ score and sleep duration (r = -0.84), indicating that a shorter sleep duration is associated with a higher incidence of situational vertigo. Smartphone use was positively correlated 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 were also associated with higher susceptibility to vertigo. These findings suggest that excessive smartphone use may lead to sleep disturbances, which contribute to vertigo. Increased awareness of these relationships can inform the development of preventive measures and counseling strategies for students on college campuses and aid health care providers in managing patients with vertigo.

Purpose: Over-the-counter (OTC) hearing aids can potentially improve access to hearing-health care and enable individuals with mild-to-moderate hearing loss to self-manage their condition. This study compared 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 participated in this study. Data Collection and Analysis: Participants were randomly assigned to two of six OTC-SF hearing aids and used the manufacturer-provided instructions and smartphone applications. These hearing aids 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 aid skills and knowledge (HASK), self-reported ease of the SF process, and Post-Study System Usability Questionnaire (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 Hearing PRO achieving the lowest score (6.8/10). Self-reported ease of SF and PSSUQ scores did not differ significantly between the OTC-SF hearing aids. Overall sound quality and clarity ratings significantly differed, with Lexie B2 receiving the highest rating (8.1/10 and 7.5/10) and HP Hearing PRO receiving the lowest rating (6.3/10 and 5.1/10). Speech-in-noise benefit did not differ significantly between devices. A thematic analysis identified seven themes of the participants' SF experiences and six themes of the researcher's field notes. Participants generally considered OTC-SF hearing aids user-friendly, although issues with Bluetooth connectivity, handling and insertion, and sound quality were noted by the researcher as common challenges. Conclusions: Usability and performance of OTC-SF hearing aids were similar across devices in terms of usability 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 the decisions of consumers and recommendations of health-care professionals. Further research of the long-term usability and selection processes of OTC-SF hearing aids is necessary.

Background: There is a need for more laboratory tests in the diagnosis of Ménière's disease (MD). Purpose: The adequacy of the findings of the video ocular counter-roll reflex (OCR) test to support the diagnosis of patients with unilateral MD in the nonattack period was investigated. Research Design: Hearing tests, ocular and cervical vestibular evoked myogenic potential (VEMP), Dizziness Handicap Inventory, and video OCR tests were performed on 31 patients with unilateral MD and 30 healthy controls, and the findings were compared. Study Sample: There were 10 males and 21 females (51.22 ± 12.76 years) in the MD group and 12 males and 18 females (46.43 ± 9.98) in the control group. Data Collection and Analysis: The significance of the difference between groups was analyzed using the Mann-Whitney U test for continuous data and the chi-squared test for categorical data. OCR degrees in the MD group were analyzed using the Wilcoxon test. A correlation matrix and intraclass correlation coefficients were also calculated to analyze the test-retest reliability of OCR degrees with the participant's head tilted at 15, 30, and 40°. Results: In the ocular VEMP test, the N1-P1 amplitudes of both ipsilesional (p < 0.001) and contralesional ears (p = 0.015) were significantly lower in the MD group than in the control group. In the cervical VEMP test, the P1-N1 amplitudes of the ipsilesional (p < 0.001) and the contralesional sides (p = 0.006) were significantly lower in the MD group than in the control group. The OCR degrees did not show a significant difference between the MD and control groups, except for the 30th-second OCR degree of the right eye when the head was tilted 30° to the ipsilesional side (p = 0.031) and the 20th-second OCR degree of the right eye when the head was tilted 40° to the ipsilesional side (p = 0.036). Conclusions: The video OCR (vOCR) test did not discriminate between the pathological and nonpathological ears in patients with unilateral MD during a nonattack period. Furthermore, the vOCR results did not discriminate between the patients with unilateral MD and the healthy controls. To obtain consistent vOCR degrees a head tilt of at least 30° and a recording time of at least 40 seconds may be required.

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.

Conclusion:  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:  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 infraorbital (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, 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 nonsimultaneous 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 to 30 years.

Data collection and analysis:  Tone bursts of octave and mid-octave frequencies from 250 to 4000 Hz were generated and concatenated to create the modified SiMFy stimulus. All participants underwent NSM 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 NSM stimulation and modified SiMFy stimulation. Although the response rates were comparable, the modified SiMFy produced significantly lower oVEMP amplitudes than the NSM stimulation within each electrode montage (p < 0.05). A moderate-to-strong agreement on frequency tuning existed between the NSM 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 NSM 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 NSM recording using IO montage.

Background:  Hearing loss significantly affects an individual's well-being, communication, social interaction, and quality of life. Cochlear implants serve as a viable management option. Given the variability in the impact of impairment, self-report measures are crucial for evaluating the perceived benefits of management options.

Purpose:  The study aims to assess the reliability of the International Outcome Inventory for Cochlear Implants (IOI-CI) and establish evaluative cutoffs. This questionnaire evaluates patient's satisfaction with cochlear implants and contributes to the understanding of their experiences, addressing the increasing interest among cochlear implant clinicians.

Research design:  The design relies on electronic medical databases within the Veterans Affairs and Department of Defense systems. After identification of eligibility, recruitment was based on participants responding to mailed study documents. This research adopts a descriptive approach of the analysis of questionnaire responses as well as quantitatively evaluating the reliability.

Study sample:  Forty-nine service members, Veterans, and their dependents, including 32 men and 17 women, participated in the study. The participants had a mean age of 68.0 years, with cochlear implants ranging from 6 months to 2 years postinitial stimulation. The majority had a unilateral cochlear implant with a hearing aid on the contralateral ear.

Data collection and analysis:  Data collected involved mailing baseline study packets, including the IOI-CI questionnaire, to potential participants identified through medical databases. Participants indicated consent by returning the study packet. Follow-up packets were sent at a later time. Intraclass correlation coefficients were utilized for test-retest reliability and generalized linear models (GLM) for exploring the impact of clinical and demographic factors. Data were analyzed using R.

Results:  The ICC revealed a good level of agreement (ICC = 0.84) between baseline and follow-up assessments for the IOI-CI total score. The GLM did not identify significant factors influencing IOI-CI scores. Evaluative values were established, indicating total scores between 18 and 35 as within the range of general satisfaction with a cochlear implant for this questionnaire.

Conclusion:  The study contributes valuable insights into the reliability of the IOI-CI and establishes evaluative cutoffs, aiding clinicians in assessing cochlear implant users' experiences and satisfaction.

Objective:  To determine the readability and quality of both English and Spanish Web sites for the topic of hearing aids.

Study design:  Cross-sectional Web site analysis.

Setting:  Various online search engines.

Methods:  The term "hearing aid" was queried across four popular search engines. The first resulted 75 English Web sites and first resulted 75 Spanish Web sites were extracted for data collection. Web sites that met the inclusion criteria were stratified by the presence of a Health on the Net Code (HONCode) certificate. Articles were then compiled to be independently reviewed by experts on hearing aids, using the DISCERN criteria, which allowed assessment of the quality of the Web sites. Readability was assessed by calculating the Flesch Reading Ease Score in English and the Fernandez Huerta Formula in Spanish. Readability and quality were both analyzed, comparing scores to their respective language and cross-comparing.

Results:  There were 37 English Web sites and 30 Spanish Web sites that met inclusion criteria. When analyzing readability, English Web sites were determined to be significantly more difficult to read (average = 55.37, standard deviation [SD] = 7.73, 95% confidence interval [CI] = 52.9-57.9) than the Spanish Web site counterparts (average = 58.64, SD = 5.26, 95% CI = 56.8-60.5, p = 0.035). For quality, Spanish Web sites (average = 38, SD = 9.7, 95% CI = 34.5-41.5) were determined to be of significantly higher quality than English Web sites (average = 32.16, SD = 10.60, 95% CI = 29.7-34.6). Additionally, there was a significant difference between the non-HONCode English Web sites versus the non-HONCode Spanish Web sites (p = 0.0081), signifying that Spanish non-HONCode certified Web sites were less reliable than non-HONCode certified English Web sites.

Discussion:  The present study highlights the importance and necessity of providing quality, readable materials to patients seeking information regarding hearing aids. This study shows that both English and Spanish Web sites are written at a level that is much higher than the American Medical Association (AMA)-recommended sixth-grade reading level, and no Web site included in this study fell at or below the AMA-recommended sixth-grade reading level. English and Spanish Web sites also lacked consistency and quality, as evidenced by their wide variability in DISCERN scores. Specifically, Hispanic patients are more likely to suffer long-term consequences of their health care due to low levels of health literacy. It is important to bridge this gap by providing adequate reading materials. It is especially important to provide evidence-based claims that are directly supported by experts in the field.

Background:  Music-induced hearing loss (MIHL) is a critical public health issue. During music instruction, students and teachers are at risk of developing hearing loss due to exposure to loud and unsafe sound levels that can exceed 100 dBA. Prevention of MIHL in music students must be a desired action of all music educators.

Purpose:  To promote deliberate changes in music instruction and encourage more moderate sound creation and exposure during music education, it is essential to equip the instructors with live dynamic tools to monitor the overall sound intensities during music instruction. Equally important data to convey to the instructors are information regarding the intensity and duration of sounds at specific frequency regions in the music they are generating. Unfortunately, there are no feasible techniques to track cumulative live music exposures at various frequencies nor are there any guidelines for safe music exposure.

Research design:  We created a visually appealing, user-friendly dashboard prototype system to display the accumulated time and intensity of sound exposure during live classes/rehearsals categorized into three frequency ranges. These visuals can be easily understood at a glance allowing musicians and instructors to make informed decisions about how to play music safely.

Experimental approach and results:  The dashboard included a collection of circular dial graphs that displayed in real time the accumulated sound exposure in the instructor's selected frequency range and showed the percentage of the maximum daily sound exposure based on the National Institute for Occupational Safety and Health Standards (NIOSH, 1998). Although NIOSH standards are not widely applied for music exposure, we propose that these standards can be used to provide initial guidelines to develop critical levels of music exposure. Additionally, the dashboard included a color-coded equalizer that displayed the instantaneous frequency distribution of sounds to indicate if sound levels at specific frequencies were too high even for short-term exposure.

Conclusion:  Less expensive than existing technology and more convenient to use, this dashboard will enable music instructors to make informed decisions on how to best adapt their teaching approaches to protect the hearing health of their students.