Worldwide, thousands of patients with severe to profound hearing loss restore their hearing with cochlear implant (CI) devices. Newer developments in electrode design and manufacturing and a better understanding of cochlear mechanics allow for conserving critical structures, often translating into serviceable residual hearing and improving device performance. Monitoring insertion speed and intraluminal pressure helps mitigate some of these challenges. However, the information becomes available after irreparable damage has occurred.We developed and tested a high-resolution optical system to navigate the intricate anatomy of the cochlea during electrode insertion. The miniaturized optical system was integrated in conventional cochlear implants electrode arrays and custom-made cochlear probes. Electrode insertion were conducted in eight cadaveric human temporal bones and video recordings were acquired. Micro-computed tomography (μCT) scans were performed to evaluate the position of the modified electrode arrays.Full insertions of the modified CI electrode were successfully conducted and verified by μCT scans. Video recordings of the cochlear structures visible in scala tympani were acquired, and no scala migration was detected.Surgeons can now follow the CI electrode's path during its insertion and reduce cochlear damage through early interventions and steering of the CI electrode. Our device will be compatible with robotic platforms that are already available to insert these electrodes.
在全球范围内，成千上万的重度到极重度听力损失患者通过人工耳蜗（CI）设备恢复了听力。电极设计和制造方面的最新发展以及对人工耳蜗力学的更好理解，使得保留关键结构成为可能，这通常可以转化为可用的残余听力并提高设备性能。监测插入速度和腔内压力有助于减轻其中的一些挑战。我们开发并测试了一种高分辨率光学系统，用于在电极插入过程中导航耳蜗复杂的解剖结构。微型光学系统集成在传统人工耳蜗电极阵列和定制的人工耳蜗探头中。在八具尸体颞骨上进行了电极插入，并采集了视频记录。通过微计算机断层扫描（μCT），对改良电极阵列的位置进行了评估。外科医生现在可以在 CI 电极插入过程中跟踪其路径，并通过早期干预和 CI 电极转向来减少耳蜗损伤。我们的设备将与现有的插入这些电极的机器人平台兼容。
{"title":"Optical method to preserve residual hearing in patients receiving a cochlear implant","authors":"Joaquin Cury, Arnaldo Rivera, Rebecca Schneider, Ray Tan, Xiaodong Tan, Claus-Peter Richter","doi":"10.3389/fauot.2024.1376699","DOIUrl":"https://doi.org/10.3389/fauot.2024.1376699","url":null,"abstract":"Worldwide, thousands of patients with severe to profound hearing loss restore their hearing with cochlear implant (CI) devices. Newer developments in electrode design and manufacturing and a better understanding of cochlear mechanics allow for conserving critical structures, often translating into serviceable residual hearing and improving device performance. Monitoring insertion speed and intraluminal pressure helps mitigate some of these challenges. However, the information becomes available after irreparable damage has occurred.We developed and tested a high-resolution optical system to navigate the intricate anatomy of the cochlea during electrode insertion. The miniaturized optical system was integrated in conventional cochlear implants electrode arrays and custom-made cochlear probes. Electrode insertion were conducted in eight cadaveric human temporal bones and video recordings were acquired. Micro-computed tomography (μCT) scans were performed to evaluate the position of the modified electrode arrays.Full insertions of the modified CI electrode were successfully conducted and verified by μCT scans. Video recordings of the cochlear structures visible in scala tympani were acquired, and no scala migration was detected.Surgeons can now follow the CI electrode's path during its insertion and reduce cochlear damage through early interventions and steering of the CI electrode. Our device will be compatible with robotic platforms that are already available to insert these electrodes.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"56 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.3389/fauot.2024.1388252
Malavika Puthiyadath, P. Prabhu, K. Nisha
Tinnitus, characterized by the perception of auditory phantoms, is prevalent worldwide and can lead to a range of hearing-related issues. Understanding its influence on temporal processing helps to delineate the auditory manifestations of tinnitus. This systematic review aimed to identify the patterns of temporal processing difficulties in individuals with tinnitus and normal hearing abilities. Furthermore, this review evaluates the potential of specific measurement techniques as tools for diagnosing temporal processing deficits in tinnitus.A comprehensive search was conducted in multiple international databases, followed by rigorous screening of the titles, abstracts, and full-length content. The inclusion and exclusion criteria were formulated using the Population, intervention, compression, Outcome, and Study design (PICOS) format, and the study bias was determined. After excluding irrelevant articles, nine studies were selected for the analysis.Over 50% of the selected studies demonstrated a significant impact on temporal processing in individuals with tinnitus, especially with gap detection test (GDT) and gaps in noise (GIN) tests, indicating of the deficits in peripheral temporal process in tinnitus individuals with normal hearing. However, the other central auditory tests showed no major changes.The findings from this review underscore the importance of understanding temporal processing impairments in tinnitus and hold promise for enhancing the diagnostic accuracy and treatment outcomes, ultimately improving the lives of those affected by tinnitus. This review highlights the potential of the GDT and GIN tests as sensitive tools for assessing temporal processing deficits in the peripheral auditory system, which in turn can manifest as central changes in temporal processing.http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021287194, Prospero [CRD42021287194].
{"title":"Temporal processing abilities in normal hearing individuals with tinnitus: a systematic review","authors":"Malavika Puthiyadath, P. Prabhu, K. Nisha","doi":"10.3389/fauot.2024.1388252","DOIUrl":"https://doi.org/10.3389/fauot.2024.1388252","url":null,"abstract":"Tinnitus, characterized by the perception of auditory phantoms, is prevalent worldwide and can lead to a range of hearing-related issues. Understanding its influence on temporal processing helps to delineate the auditory manifestations of tinnitus. This systematic review aimed to identify the patterns of temporal processing difficulties in individuals with tinnitus and normal hearing abilities. Furthermore, this review evaluates the potential of specific measurement techniques as tools for diagnosing temporal processing deficits in tinnitus.A comprehensive search was conducted in multiple international databases, followed by rigorous screening of the titles, abstracts, and full-length content. The inclusion and exclusion criteria were formulated using the Population, intervention, compression, Outcome, and Study design (PICOS) format, and the study bias was determined. After excluding irrelevant articles, nine studies were selected for the analysis.Over 50% of the selected studies demonstrated a significant impact on temporal processing in individuals with tinnitus, especially with gap detection test (GDT) and gaps in noise (GIN) tests, indicating of the deficits in peripheral temporal process in tinnitus individuals with normal hearing. However, the other central auditory tests showed no major changes.The findings from this review underscore the importance of understanding temporal processing impairments in tinnitus and hold promise for enhancing the diagnostic accuracy and treatment outcomes, ultimately improving the lives of those affected by tinnitus. This review highlights the potential of the GDT and GIN tests as sensitive tools for assessing temporal processing deficits in the peripheral auditory system, which in turn can manifest as central changes in temporal processing.http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021287194, Prospero [CRD42021287194].","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140740631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.3389/fauot.2024.1362443
Sho Kurihara, A. Ganaha, Takeshi Nakamura, Kan Kubuki, Emi Saruwatari, Koudai Matsui, Kuniyuki Takahashi, Tetsuya Tono
Bone-conduction devices can be considered a viable treatment option for patients experiencing asymmetric hearing loss (AHL), especially those with severe to profound hearing loss (HL) present in one ear. However, there are only a few reports on the effects of bone-anchored hearing aids (BAHAs) on patients with AHL. This retrospective study analyzed in detail the effects of BAHA on softer sounds than other hearing aids and identified situations in which BAHA had a negative effect.Patients with AHL, characterized by severe to profound hearing loss in one ear with a difference of ≥45 dB from that of the contralateral ear, underwent BAHA implantation in the ear with worse hearing. The BAHA effects were evaluated by assessing the word recognition score (WRS) and speech reception threshold (SRT) using the Japanese Oldenburg Sentence Test for various signal settings and noise directions. For a subjective analysis, the Speech, Spatial and Qualities of Hearing Scale (SSQ12) score was determined.Thirteen patients who underwent BAHA implantation at the Miyazaki University Hospital between 2007 and 2021 were included. The BAHA demonstrated a significant improvement in the WRS from 40 to 70 dB sound pressure levels. Although the SRT showed significant improvement in noisy environments when speech was presented to the BAHA-wearing side, it worsened significantly when noise was presented to this side. In the survey of subjective hearing ability, both the total and subscale SSQ12 scores improved significantly after wearing the BAHA.This study identified scenarios in which BAHAs were beneficial and detrimental to individuals with AHL. Generally used audiological tests, such as the WRS with fixed sound pressure, may underestimate the effectiveness of BAHAs for softer sounds. In addition, depending on the direction of the noise, BAHAs may have adverse effects. These results could help patients comprehend the potential benefits and limitations of bone-conduction devices for their hearing.
对于非对称性听力损失（AHL）患者，尤其是单耳重度至极重度听力损失（HL）患者来说，骨导助听器是一种可行的治疗方法。然而，有关骨导助听器（BAHA）对非对称性听力损失患者影响的报道却寥寥无几。这项回顾性研究详细分析了 BAHA 对比起其他助听器更柔和的声音的影响，并确定了 BAHA 产生负面影响的情况。AHL 患者的特征是一耳重度到极重度听力损失，与对侧耳的听力差距≥45 dB，他们在听力较差的一耳接受了 BAHA 植入手术。评估 BAHA 效果的方法是在不同信号设置和噪声方向下，使用日本奥登堡句子测试评估单词识别得分（WRS）和语音接收阈值（SRT）。为了进行主观分析，还测定了言语、空间和听力质量量表（SSQ12）的得分。从 40 到 70 dB 声压级之间，BAHA 的 WRS 有明显改善。虽然在嘈杂环境中，向佩戴 BAHA 的一侧播放语音时，SRT 有明显改善，但向佩戴 BAHA 的一侧播放噪音时，SRT 则明显恶化。在主观听力能力调查中，佩戴 BAHA 后，SSQ12 的总分和分值都有明显改善。一般使用的听力测试，如固定声压的 WRS，可能会低估 BAHA 对较柔和声音的效果。此外，根据噪音的方向，BAHA 可能会产生不利影响。这些结果可以帮助患者理解骨传导设备对其听力的潜在益处和局限性。
{"title":"Pros and cons of a bone-conduction device implanted in the worse hearing ear of patients with asymmetric hearing loss","authors":"Sho Kurihara, A. Ganaha, Takeshi Nakamura, Kan Kubuki, Emi Saruwatari, Koudai Matsui, Kuniyuki Takahashi, Tetsuya Tono","doi":"10.3389/fauot.2024.1362443","DOIUrl":"https://doi.org/10.3389/fauot.2024.1362443","url":null,"abstract":"Bone-conduction devices can be considered a viable treatment option for patients experiencing asymmetric hearing loss (AHL), especially those with severe to profound hearing loss (HL) present in one ear. However, there are only a few reports on the effects of bone-anchored hearing aids (BAHAs) on patients with AHL. This retrospective study analyzed in detail the effects of BAHA on softer sounds than other hearing aids and identified situations in which BAHA had a negative effect.Patients with AHL, characterized by severe to profound hearing loss in one ear with a difference of ≥45 dB from that of the contralateral ear, underwent BAHA implantation in the ear with worse hearing. The BAHA effects were evaluated by assessing the word recognition score (WRS) and speech reception threshold (SRT) using the Japanese Oldenburg Sentence Test for various signal settings and noise directions. For a subjective analysis, the Speech, Spatial and Qualities of Hearing Scale (SSQ12) score was determined.Thirteen patients who underwent BAHA implantation at the Miyazaki University Hospital between 2007 and 2021 were included. The BAHA demonstrated a significant improvement in the WRS from 40 to 70 dB sound pressure levels. Although the SRT showed significant improvement in noisy environments when speech was presented to the BAHA-wearing side, it worsened significantly when noise was presented to this side. In the survey of subjective hearing ability, both the total and subscale SSQ12 scores improved significantly after wearing the BAHA.This study identified scenarios in which BAHAs were beneficial and detrimental to individuals with AHL. Generally used audiological tests, such as the WRS with fixed sound pressure, may underestimate the effectiveness of BAHAs for softer sounds. In addition, depending on the direction of the noise, BAHAs may have adverse effects. These results could help patients comprehend the potential benefits and limitations of bone-conduction devices for their hearing.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"53 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-15DOI: 10.3389/fauot.2024.1342263
M. Grasmeder, Katrine Rogers, Ziya Aydin, Kate Hough, Carl Verschuur, Tracey Newman
Identification of faults with the internal, implanted, part of a cochlear implant presents a challenge for the cochlear implant community. Advanced Bionics Ultra V1 devices are vulnerable to moisture ingress, a hard failure, resulting in reduced volume and clarity for the recipient. The manufacturer uses a trans-impedance test “Electrical Field Imaging” to identify faulty Ultra V1 devices but reports the sensitivity of the test to be only 70–90%.In our clinic we performed Electrode Voltage measurements with surface electrodes and have compared the two tests. Electrical Field imaging and Electrode Voltage (EV) measurements were available for 65 devices. Surface electrodes were attached to the earlobes and forehead and potentials measured in three montages: ipsilateral earlobe and forehead, contralateral earlobe and forehead, and both earlobes; voltages were extracted and relative voltages across the array were calculated.Relative EV were compared for the two earlobes montage and fitted to a third order polynomial function. A new criterion for identifying faulty devices was derived, with a deviation of < 6% for individual electrodes for normally functioning devices or ≥6% for faulty devices. All devices which were normal according to the new criterion (N = 15) had a normal electrical field imaging test, whilst 17/50 devices which were abnormal had normal electrical field imaging and 33/50 which were abnormal had abnormal electrical field imaging.The REVs test was well-tolerated and carried out in a routine cochlear implant clinic. Together with test sensitivity and reliability this may make it a new routine assessment tool to aid in distinguishing hard and soft failures.
{"title":"Improving the sensitivity of cochlear implant integrity testing by recording electrode voltages with surface electrodes","authors":"M. Grasmeder, Katrine Rogers, Ziya Aydin, Kate Hough, Carl Verschuur, Tracey Newman","doi":"10.3389/fauot.2024.1342263","DOIUrl":"https://doi.org/10.3389/fauot.2024.1342263","url":null,"abstract":"Identification of faults with the internal, implanted, part of a cochlear implant presents a challenge for the cochlear implant community. Advanced Bionics Ultra V1 devices are vulnerable to moisture ingress, a hard failure, resulting in reduced volume and clarity for the recipient. The manufacturer uses a trans-impedance test “Electrical Field Imaging” to identify faulty Ultra V1 devices but reports the sensitivity of the test to be only 70–90%.In our clinic we performed Electrode Voltage measurements with surface electrodes and have compared the two tests. Electrical Field imaging and Electrode Voltage (EV) measurements were available for 65 devices. Surface electrodes were attached to the earlobes and forehead and potentials measured in three montages: ipsilateral earlobe and forehead, contralateral earlobe and forehead, and both earlobes; voltages were extracted and relative voltages across the array were calculated.Relative EV were compared for the two earlobes montage and fitted to a third order polynomial function. A new criterion for identifying faulty devices was derived, with a deviation of < 6% for individual electrodes for normally functioning devices or ≥6% for faulty devices. All devices which were normal according to the new criterion (N = 15) had a normal electrical field imaging test, whilst 17/50 devices which were abnormal had normal electrical field imaging and 33/50 which were abnormal had abnormal electrical field imaging.The REVs test was well-tolerated and carried out in a routine cochlear implant clinic. Together with test sensitivity and reliability this may make it a new routine assessment tool to aid in distinguishing hard and soft failures.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139774566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-15DOI: 10.3389/fauot.2024.1342263
M. Grasmeder, Katrine Rogers, Ziya Aydin, Kate Hough, Carl Verschuur, Tracey Newman
Identification of faults with the internal, implanted, part of a cochlear implant presents a challenge for the cochlear implant community. Advanced Bionics Ultra V1 devices are vulnerable to moisture ingress, a hard failure, resulting in reduced volume and clarity for the recipient. The manufacturer uses a trans-impedance test “Electrical Field Imaging” to identify faulty Ultra V1 devices but reports the sensitivity of the test to be only 70–90%.In our clinic we performed Electrode Voltage measurements with surface electrodes and have compared the two tests. Electrical Field imaging and Electrode Voltage (EV) measurements were available for 65 devices. Surface electrodes were attached to the earlobes and forehead and potentials measured in three montages: ipsilateral earlobe and forehead, contralateral earlobe and forehead, and both earlobes; voltages were extracted and relative voltages across the array were calculated.Relative EV were compared for the two earlobes montage and fitted to a third order polynomial function. A new criterion for identifying faulty devices was derived, with a deviation of < 6% for individual electrodes for normally functioning devices or ≥6% for faulty devices. All devices which were normal according to the new criterion (N = 15) had a normal electrical field imaging test, whilst 17/50 devices which were abnormal had normal electrical field imaging and 33/50 which were abnormal had abnormal electrical field imaging.The REVs test was well-tolerated and carried out in a routine cochlear implant clinic. Together with test sensitivity and reliability this may make it a new routine assessment tool to aid in distinguishing hard and soft failures.
{"title":"Improving the sensitivity of cochlear implant integrity testing by recording electrode voltages with surface electrodes","authors":"M. Grasmeder, Katrine Rogers, Ziya Aydin, Kate Hough, Carl Verschuur, Tracey Newman","doi":"10.3389/fauot.2024.1342263","DOIUrl":"https://doi.org/10.3389/fauot.2024.1342263","url":null,"abstract":"Identification of faults with the internal, implanted, part of a cochlear implant presents a challenge for the cochlear implant community. Advanced Bionics Ultra V1 devices are vulnerable to moisture ingress, a hard failure, resulting in reduced volume and clarity for the recipient. The manufacturer uses a trans-impedance test “Electrical Field Imaging” to identify faulty Ultra V1 devices but reports the sensitivity of the test to be only 70–90%.In our clinic we performed Electrode Voltage measurements with surface electrodes and have compared the two tests. Electrical Field imaging and Electrode Voltage (EV) measurements were available for 65 devices. Surface electrodes were attached to the earlobes and forehead and potentials measured in three montages: ipsilateral earlobe and forehead, contralateral earlobe and forehead, and both earlobes; voltages were extracted and relative voltages across the array were calculated.Relative EV were compared for the two earlobes montage and fitted to a third order polynomial function. A new criterion for identifying faulty devices was derived, with a deviation of < 6% for individual electrodes for normally functioning devices or ≥6% for faulty devices. All devices which were normal according to the new criterion (N = 15) had a normal electrical field imaging test, whilst 17/50 devices which were abnormal had normal electrical field imaging and 33/50 which were abnormal had abnormal electrical field imaging.The REVs test was well-tolerated and carried out in a routine cochlear implant clinic. Together with test sensitivity and reliability this may make it a new routine assessment tool to aid in distinguishing hard and soft failures.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"428 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139834377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-11DOI: 10.3389/fauot.2023.1298936
Elza Daoud, Falco Enzler, Philippe Fournier, Arnaud J. Noreña
Psychoacoustic measures are used to quantify tinnitus perception in clinical and research settings. Residual inhibition (RI), for instance, is defined as a temporary reduction in tinnitus loudness after the presentation of an acoustic stimulus. A novel approach was developed recently to assess the minimum sound level producing RI, the minimum residual inhibition level (MRIL), after the repeated presentation of short sounds separated by short periods of silence. Two studies were performed: the objective of the study 1 was to assess the reliability and the reproducibility of this measures as well as others, including the minimum masking level (MML). The objective of study 2 was to assess whether a smoother envelope of the sound would produce similar levels of MML and MRIL and improve listening comfort.Thirty participants with chronic tinnitus completed each study. For study 1, MML and MRIL were obtained at the seven standard audiometric frequencies at around 1-month interval. For study 2, MML and MRIL were obtained using triangular and trapezoidal-shaped NBN signals centered at three different frequencies.The mean absolute test-retest difference was 3 dB for both MML and MRIL [Intraclass correlation, ICC (2,1) of 0.70 and 0.84, respectively] for the measures obtained in test and retest (86% of cases for MML and 21% of cases for complete MRIL). While the two types of envelopes provided comparable MRIL, the “triangular” envelope provided more listening comfort.In sum, the novel approach provides quick and reliable MML and MRIL measurement, with the potential benefit of subtyping participants.
{"title":"Reliability of some tinnitus psychoacoustic measures","authors":"Elza Daoud, Falco Enzler, Philippe Fournier, Arnaud J. Noreña","doi":"10.3389/fauot.2023.1298936","DOIUrl":"https://doi.org/10.3389/fauot.2023.1298936","url":null,"abstract":"Psychoacoustic measures are used to quantify tinnitus perception in clinical and research settings. Residual inhibition (RI), for instance, is defined as a temporary reduction in tinnitus loudness after the presentation of an acoustic stimulus. A novel approach was developed recently to assess the minimum sound level producing RI, the minimum residual inhibition level (MRIL), after the repeated presentation of short sounds separated by short periods of silence. Two studies were performed: the objective of the study 1 was to assess the reliability and the reproducibility of this measures as well as others, including the minimum masking level (MML). The objective of study 2 was to assess whether a smoother envelope of the sound would produce similar levels of MML and MRIL and improve listening comfort.Thirty participants with chronic tinnitus completed each study. For study 1, MML and MRIL were obtained at the seven standard audiometric frequencies at around 1-month interval. For study 2, MML and MRIL were obtained using triangular and trapezoidal-shaped NBN signals centered at three different frequencies.The mean absolute test-retest difference was 3 dB for both MML and MRIL [Intraclass correlation, ICC (2,1) of 0.70 and 0.84, respectively] for the measures obtained in test and retest (86% of cases for MML and 21% of cases for complete MRIL). While the two types of envelopes provided comparable MRIL, the “triangular” envelope provided more listening comfort.In sum, the novel approach provides quick and reliable MML and MRIL measurement, with the potential benefit of subtyping participants.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"35 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-11DOI: 10.3389/fauot.2023.1323864
Harriet Smith, Kathryn Fackrell, V. Kennedy, Johanna G. Barry, Claire Benton, Lucy Partridge, D. Hoare
Tinnitus is a common disorder of the auditory system. Questionnaires are essential tools for clinical assessment and research. Whilst many questionnaires are available to measure different aspects of tinnitus complaint in adults, there is currently no self-report questionnaire measure of tinnitus that has been developed for or is suitable for use with children. This study describes the development of the first self-report measure of tinnitus impact for children aged 8–16 years old.Two phases of questionnaire development were conducted. In Phase 1 children's tinnitus-related problems were elicited from interviews with children with tinnitus (n = 11; aged 9–16 years old), parents (n = 5), and clinicians (n = 8). Interview transcripts were analyzed using qualitative content analysis. Findings were combined with problems identified by the clinical co-authors, researchers, and clinicians in a conference workshop, and those previously reported in service evaluation of UK National Health Service pediatric tinnitus services and in a scoping review. From this, a conceptual framework of tinnitus impact on health-related quality of life in children was developed. Based on the conceptual framework, a 38-item pilot questionnaire was drafted. In Phase 2, content validity of the pilot questionnaire was assessed in cognitive interviews with six children who had tinnitus (aged 8–15 years old) and an online survey with clinicians working in pediatric tinnitus services (n = 8 services and 28 clinicians). Finally, readability assessments were conducted. Feedback led to iterative revisions to the questionnaire. The final questionnaire was named the Impact of Tinnitus in Children Questionnaire (iTICQ).The iTICQ contains three scene setting (non-scoring) items, and 33 scoring items covering six domains of tinnitus impact: Sleep and Feeling Tired, Learning, Emotional Health, Hearing and Listening, Taking Part, and Relationships.The iTICQ is a new self-report measure of tinnitus impact that can be self-completed by children aged 8–16 years old. It shows good content validity and can be used to measure problem severity across the domains of core relevance to children with tinnitus. Further validation studies and translations of the iTICQ are indicated to determine its psychometric properties in different child populations and to make it widely accessible.
{"title":"Development of the impact of tinnitus in children questionnaire (iTICQ)","authors":"Harriet Smith, Kathryn Fackrell, V. Kennedy, Johanna G. Barry, Claire Benton, Lucy Partridge, D. Hoare","doi":"10.3389/fauot.2023.1323864","DOIUrl":"https://doi.org/10.3389/fauot.2023.1323864","url":null,"abstract":"Tinnitus is a common disorder of the auditory system. Questionnaires are essential tools for clinical assessment and research. Whilst many questionnaires are available to measure different aspects of tinnitus complaint in adults, there is currently no self-report questionnaire measure of tinnitus that has been developed for or is suitable for use with children. This study describes the development of the first self-report measure of tinnitus impact for children aged 8–16 years old.Two phases of questionnaire development were conducted. In Phase 1 children's tinnitus-related problems were elicited from interviews with children with tinnitus (n = 11; aged 9–16 years old), parents (n = 5), and clinicians (n = 8). Interview transcripts were analyzed using qualitative content analysis. Findings were combined with problems identified by the clinical co-authors, researchers, and clinicians in a conference workshop, and those previously reported in service evaluation of UK National Health Service pediatric tinnitus services and in a scoping review. From this, a conceptual framework of tinnitus impact on health-related quality of life in children was developed. Based on the conceptual framework, a 38-item pilot questionnaire was drafted. In Phase 2, content validity of the pilot questionnaire was assessed in cognitive interviews with six children who had tinnitus (aged 8–15 years old) and an online survey with clinicians working in pediatric tinnitus services (n = 8 services and 28 clinicians). Finally, readability assessments were conducted. Feedback led to iterative revisions to the questionnaire. The final questionnaire was named the Impact of Tinnitus in Children Questionnaire (iTICQ).The iTICQ contains three scene setting (non-scoring) items, and 33 scoring items covering six domains of tinnitus impact: Sleep and Feeling Tired, Learning, Emotional Health, Hearing and Listening, Taking Part, and Relationships.The iTICQ is a new self-report measure of tinnitus impact that can be self-completed by children aged 8–16 years old. It shows good content validity and can be used to measure problem severity across the domains of core relevance to children with tinnitus. Further validation studies and translations of the iTICQ are indicated to determine its psychometric properties in different child populations and to make it widely accessible.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"29 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-30DOI: 10.3389/fauot.2023.1277872
K. Chua, Jing Deng, Heng Wai Yuen
Patients with chronic dizziness often have an unremarkable laboratory vestibular examination and have medical clearance from other specialties. However, functional impairments are still significant and affect patients' quality of life. Recent diagnostic criteria and identification of persistent postural perceptual dizziness (PPPD) have helped us to better understand the psychological-somatic manifestations of organic disorders. As the literature suggests good efficacy using a combination of cognitive behavior therapy (CBT) and vestibular rehabilitation, we compared the efficacy of a hybrid protocol using dizziness handicap inventory (DHI) as an outcome measure amongst the different sub-types of chronic dizziness.This was an observational study with 35 participants allocated to three different groups: those who strictly fulfilled the PPPD criteria, those with spontaneous episodic vestibular syndrome, and participants with non-specific dizziness. We compared the DHI total and sub-domain scores at baseline and 6 months post-intervention for differences. All participants undertook three sessions in 6 months.The total DHI scores were reduced in all three groups. However, the DHI total on average was 11 points higher in the episodic vestibular syndrome group. The emotional sub-domain scores were also reduced in all three groups, but the functional and physical scores were significantly higher in the episodic vestibular group.A hybrid protocol worked best for typical PPPD patients who strictly fulfilled the criteria followed by participants in the non-specific dizziness group. When symptoms were episodic in spontaneous vestibular syndrome, only emotional handicap was reduced at 6 months, but functional and physical handicap scores remained high. Regardless, the DHI total scores in all groups were significantly reduced, possibly due to CBT reducing the anxiety that results from a lack of understanding of the clinical diagnoses.
{"title":"Hybrid dizziness counseling with vestibular rehabilitation in participants with chronic dizziness: a comparison of dizziness handicap","authors":"K. Chua, Jing Deng, Heng Wai Yuen","doi":"10.3389/fauot.2023.1277872","DOIUrl":"https://doi.org/10.3389/fauot.2023.1277872","url":null,"abstract":"Patients with chronic dizziness often have an unremarkable laboratory vestibular examination and have medical clearance from other specialties. However, functional impairments are still significant and affect patients' quality of life. Recent diagnostic criteria and identification of persistent postural perceptual dizziness (PPPD) have helped us to better understand the psychological-somatic manifestations of organic disorders. As the literature suggests good efficacy using a combination of cognitive behavior therapy (CBT) and vestibular rehabilitation, we compared the efficacy of a hybrid protocol using dizziness handicap inventory (DHI) as an outcome measure amongst the different sub-types of chronic dizziness.This was an observational study with 35 participants allocated to three different groups: those who strictly fulfilled the PPPD criteria, those with spontaneous episodic vestibular syndrome, and participants with non-specific dizziness. We compared the DHI total and sub-domain scores at baseline and 6 months post-intervention for differences. All participants undertook three sessions in 6 months.The total DHI scores were reduced in all three groups. However, the DHI total on average was 11 points higher in the episodic vestibular syndrome group. The emotional sub-domain scores were also reduced in all three groups, but the functional and physical scores were significantly higher in the episodic vestibular group.A hybrid protocol worked best for typical PPPD patients who strictly fulfilled the criteria followed by participants in the non-specific dizziness group. When symptoms were episodic in spontaneous vestibular syndrome, only emotional handicap was reduced at 6 months, but functional and physical handicap scores remained high. Regardless, the DHI total scores in all groups were significantly reduced, possibly due to CBT reducing the anxiety that results from a lack of understanding of the clinical diagnoses.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139198335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-28DOI: 10.3389/fauot.2023.1298538
Luis Lassaletta, M. Calvino, Isabel Sánchez-Cuadrado, Javier Gavilán
Personalization of treatment is a growing trend in various fields of medicine, and this includes cochlear implantation. Both the precise choice of the length and shape of the electrode array to fit a particular cochlear anatomy, as well as an individualized fitting setting have been suggested to improve hearing outcomes with a cochlear implant (CI). The aim of this study was to compare anatomy-based fitting (ABF) vs. default fitting in terms of frequency-to-place mismatch, speech discrimination, and subjective outcomes in MED-EL CI users.Eight adult CI users implanted with a Synchrony ST Flex28 were enrolled prospectively. Insertion depth and tonotopic distribution of each electrode was calculated using the Otoplan software. The mismatch was calculated for each fitting strategy relative to the electrodes' tonotopic place-frequency. Speech tests and patient preference was evaluated after 9 months with ABF and 1 month after default fitting.Median angular insertion of the most apical active electrode was 594° (interquartile range 143°). ABF showed lower mismatches than default fitting in all patients (p ≤ 0.01). Mean speech discrimination score with ABF and default fitting was 73 ± 11% and 72 ± 16%, respectively (p = 0.672). Mean speech reception threshold with ABF and default fitting was 3.6 ± 3.4 dB and 4.2 ± 5.0 dB, respectively (p = 0.401). All patients except one preferred ABF when they were asked about their preference.ABF maps have a lower frequency-to-place mismatch than default fitting maps. In spite of similar hearing outcomes most patients prefer ABF. More data are necessary to corroborate the benefit of the ABF over default fitting in speech and subjective tests.
{"title":"Does it make any sense to fit cochlear implants according to the anatomy-based fitting? Our experience with the first series of patients","authors":"Luis Lassaletta, M. Calvino, Isabel Sánchez-Cuadrado, Javier Gavilán","doi":"10.3389/fauot.2023.1298538","DOIUrl":"https://doi.org/10.3389/fauot.2023.1298538","url":null,"abstract":"Personalization of treatment is a growing trend in various fields of medicine, and this includes cochlear implantation. Both the precise choice of the length and shape of the electrode array to fit a particular cochlear anatomy, as well as an individualized fitting setting have been suggested to improve hearing outcomes with a cochlear implant (CI). The aim of this study was to compare anatomy-based fitting (ABF) vs. default fitting in terms of frequency-to-place mismatch, speech discrimination, and subjective outcomes in MED-EL CI users.Eight adult CI users implanted with a Synchrony ST Flex28 were enrolled prospectively. Insertion depth and tonotopic distribution of each electrode was calculated using the Otoplan software. The mismatch was calculated for each fitting strategy relative to the electrodes' tonotopic place-frequency. Speech tests and patient preference was evaluated after 9 months with ABF and 1 month after default fitting.Median angular insertion of the most apical active electrode was 594° (interquartile range 143°). ABF showed lower mismatches than default fitting in all patients (p ≤ 0.01). Mean speech discrimination score with ABF and default fitting was 73 ± 11% and 72 ± 16%, respectively (p = 0.672). Mean speech reception threshold with ABF and default fitting was 3.6 ± 3.4 dB and 4.2 ± 5.0 dB, respectively (p = 0.401). All patients except one preferred ABF when they were asked about their preference.ABF maps have a lower frequency-to-place mismatch than default fitting maps. In spite of similar hearing outcomes most patients prefer ABF. More data are necessary to corroborate the benefit of the ABF over default fitting in speech and subjective tests.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139216476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23DOI: 10.3389/fauot.2023.1275210
K. Andersson, Tobias Neher, J. Christensen
Ecological momentary assessment (EMA) can provide insights into the real-world auditory ecology of hearing aid (HA) users. To better understand what factors, influence the real-world listening experiences of this population, more detailed models of human auditory ecology and behavior are needed. Laboratory studies suggest that physiological measures are sensitive to different listening experiences, as changes in physiological signals (e.g., pupil dilation) have been associated with effortful listening. In addition, real-world heart rate (HR) has been shown to be sensitive to acoustic influences (e.g., sound pressure level, SPL, and signal-to-noise ratio, SNR). Here, we hypothesized that including physiological and acoustic data in models predicting EMA ratings can provide additional insights into real-world listening outcome. To test this, we collected and analyzed longitudinal data from individuals with normal hearing.Fifteen normal-hearing adults completed smartphone-based EMAs regarding their listening experiences during a 2-week period. When completing the EMAs, they had to indicate their current listening intent. The participants received a single HA each that they fastened to their collars. The HAs were used to collect continuous SPL and SNR data in the participants' daily environments. Wristbands worn by the participants were used to collect continuous HR data.Linear mixed-effects models with SPL, SNR, and HR as fixed effects and participant as random intercept showed that higher SPL and lower SNR were associated with lower (poorer) EMA ratings. Including listening intent in the analyses revealed increased HR in “speech communication” and “focused listening” situations to be associated with better EMA ratings relative to situations without any specific listening intent.Our findings indicate that including in-situ HR and acoustic measurements can improve the prediction of real-world listening experiences. Further, they suggest that listening intent significantly impacts self-reported listening experiences and their association with physiological responses. Specifically, better listening experiences in speech communication situations are associated with higher HR.
生态瞬时评估（EMA）可以帮助人们深入了解助听器（HA）用户在现实世界中的听觉生态。为了更好地了解是哪些因素影响了这一人群的实际聆听体验，需要建立更详细的人类听觉生态学和行为模型。实验室研究表明，生理指标对不同的聆听体验非常敏感，因为生理信号（如瞳孔放大）的变化与努力聆听有关。此外，现实世界中的心率（HR）已被证明对声音影响（如声压级 SPL 和信噪比 SNR）很敏感。在此，我们假设将生理和声学数据纳入预测 EMA 评级的模型中，可以为真实世界的聆听结果提供更多的见解。为了验证这一假设，我们收集并分析了听力正常者的纵向数据。15 名听力正常的成年人在两周内完成了基于智能手机的 EMA，了解了他们的听力体验。在填写 EMA 时，他们必须说明当前的聆听意图。参与者每人获得一个固定在衣领上的耳机。HAs 用于收集参与者日常环境中的连续声压级和信噪比数据。以声压级、信噪比和心率为固定效应，参与者为随机截距的线性混合效应模型显示，较高的声压级和较低的信噪比与较低的（较差的）EMA评分有关。我们的研究结果表明，将现场心率和声学测量结果纳入分析，可以改善对真实世界听力体验的预测。此外，研究结果还表明，聆听意图会对自我报告的聆听体验及其与生理反应的关联产生重大影响。具体来说，在语音交流情况下，更好的聆听体验与更高的心率有关。
{"title":"Ecological momentary assessments of real-world speech listening are associated with heart rate and acoustic condition","authors":"K. Andersson, Tobias Neher, J. Christensen","doi":"10.3389/fauot.2023.1275210","DOIUrl":"https://doi.org/10.3389/fauot.2023.1275210","url":null,"abstract":"Ecological momentary assessment (EMA) can provide insights into the real-world auditory ecology of hearing aid (HA) users. To better understand what factors, influence the real-world listening experiences of this population, more detailed models of human auditory ecology and behavior are needed. Laboratory studies suggest that physiological measures are sensitive to different listening experiences, as changes in physiological signals (e.g., pupil dilation) have been associated with effortful listening. In addition, real-world heart rate (HR) has been shown to be sensitive to acoustic influences (e.g., sound pressure level, SPL, and signal-to-noise ratio, SNR). Here, we hypothesized that including physiological and acoustic data in models predicting EMA ratings can provide additional insights into real-world listening outcome. To test this, we collected and analyzed longitudinal data from individuals with normal hearing.Fifteen normal-hearing adults completed smartphone-based EMAs regarding their listening experiences during a 2-week period. When completing the EMAs, they had to indicate their current listening intent. The participants received a single HA each that they fastened to their collars. The HAs were used to collect continuous SPL and SNR data in the participants' daily environments. Wristbands worn by the participants were used to collect continuous HR data.Linear mixed-effects models with SPL, SNR, and HR as fixed effects and participant as random intercept showed that higher SPL and lower SNR were associated with lower (poorer) EMA ratings. Including listening intent in the analyses revealed increased HR in “speech communication” and “focused listening” situations to be associated with better EMA ratings relative to situations without any specific listening intent.Our findings indicate that including in-situ HR and acoustic measurements can improve the prediction of real-world listening experiences. Further, they suggest that listening intent significantly impacts self-reported listening experiences and their association with physiological responses. Specifically, better listening experiences in speech communication situations are associated with higher HR.","PeriodicalId":507438,"journal":{"name":"Frontiers in Audiology and Otology","volume":"163 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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