Journal of the American Academy of Audiology最新文献

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.

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. 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 typically 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 upbeating skull vibration-induced nystagmus.

Background:  Oculomotor and reaction time tests are frequently used assessments of vestibular symptoms, traumatic brain injury (TBI), or other neurological disorders in both clinical and research contexts. When interpreting these tests it is important to have a reference interval (RI) as a comparison for what constitutes a typical/expected response; however, the current body of research has only limited information regarding normative ranges calculated according to established standards or for a military-specific sample.

Purpose:  The purpose of the present study was to describe RIs for oculomotor and reaction time tests in a cohort of service members and veterans (SMVs) for use as comparators by clinicians and scientists.

Research design:  Descriptive.

Study sample:  Participants were prospectively enrolled in the Defense and Veterans Brain Injury Center-Traumatic Brain Injury Center of Excellence 15-year Longitudinal Traumatic Brain Injury Study. Only SMVs without a history of TBI or blast exposure were included in the RI calculations.

Data collection and analysis:  The test paradigms included in this analysis were: smooth pursuit, prosaccades, antisaccades, saccades and reaction time, predictive saccades, optokinetic nystagmus, auditory reaction time, and visual reaction time. Nonparametric methods, based on the U.S. Food and Drug Administration's recognized consensus standards, were used to calculate 95% RIs. A comparison between the calculated RIs and those available from previously published research is provided.

Results:  Summary statistics and RIs were calculated for 47 outcome parameters from 13 oculomotor and reaction time tests. Sample sizes and age ranges varied across outcome parameters depending on the availability of reference values for RI calculations. The sample sizes used to calculate RIs ranged from 51 to 69. The age of SMVs included in each RI ranged from 19 to 61 years with mean ages ranging from 37 to 39 years. Similarities/differences between the RIs in the present study and those in previously published research are highly dependent on the outcome parameter; however, in general, the RIs in the present study tended to be somewhat wider.

Conclusion:  The RIs provided in this paper can serve as comparisons for clinicians and scientists who are utilizing these oculomotor and reaction time testing paradigms in similar cohorts of patients or research participants.

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:  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:  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.