Seminars in Hearing最新文献

Standardized outcome measures are essential for evidence-based pediatric audiology practice, yet Malaysia lacks unified national guidelines, risking inconsistent care quality and inequitable service delivery for children with hearing loss. This conceptual review presents a national perspective on pediatric audiology outcome measures, synthesizing findings from expert panel discussions, literature integration, and practice assessment through triangulation. Key insights were gathered through the Seventh Malaysian Audiology Scientific Conference forum, involving structured panels with government, private sector, and international representatives, plus insights from 180 forum participants. Current landscape analysis reveals public sector services follow established protocols with government investment in equipment upgrades, while private sector practices demonstrate significant variability. Critical gaps include sector variability, absence of unified standards, inadequate inter-facility comparison capabilities, and the need for tiered implementation approaches. Implementation challenges include fragmented service delivery, limited access to advanced tools outside specialized centers, workforce and infrastructure gaps, and private sector constraints. International examples, particularly the Welsh Primary Care Audiology Pathway, demonstrate successful integration models enhancing service consistency and equity. Strategic recommendations propose a three-phase framework: foundation (stakeholder coordination), development (culturally-adapted standards), and sustainability (monitoring and evaluation). A national task force comprising key stakeholders is recommended to lead standardization efforts, ensuring consistent, evidence-based care for children with hearing loss across Malaysia's diverse healthcare settings.

Recent regulatory changes in the United States created a category of hearing aids that could be purchased over-the-counter (OTC), directly by a consumer without professional dispensing. Evidence supporting the benefits of OTC hearing aids for adults with perceived mild-to-moderate hearing difficulty is somewhat mixed in the literature. The purpose of this study is to compare hearing aid benefits and satisfaction rates for OTC and traditional, provider-dispensed hearing aids within the MarkeTrak 25 survey data. Results of the survey demonstrate robust benefits and high satisfaction rates for both OTC and traditional hearing aids. However, there are some differences in trends between OTC and traditional hearing aids. Specifically, within owners of traditional hearing aids, there is remarkable stability in terms of benefits, satisfaction rates (83% of hearing aid owners are satisfied), and net promoter scores (+30 points for promoters relative to detractors). These values are essentially unchanged over the last several years, suggesting the introduction of the formal OTC hearing aid category has not affected the benefit or satisfaction rates of traditional hearing aids. The OTC hearing aids themselves have similar benefits as traditional hearing aids, although slightly lower satisfaction rates (76% of OTC hearing aid owners are satisfied). Compared to owners of traditional hearing aids, owners of OTC hearing aids were less likely to be satisfied with the size and reliability of their hearing aids, although they were more likely to be satisfied with the price of the hearing aids. The current data also highlight the importance of professional services, even within the group of OTC hearing aid owners. Not only did most OTC hearing aid owners (approximately 80%) utilize some type of professional service, but those who did receive professional support were more likely to be satisfied with their hearing aids than were those who did not receive professional services. Therefore, although the OTC hearing aids are beneficial and consumers are satisfied with them, professional support continues to be an important and beneficial aspect in the OTC category of hearing aids.

Background: Auditory evoked potentials (AEPs), including the auditory brainstem response (ABR) and cortical auditory evoked potential (CAEP), are widely used to estimate hearing thresholds in individuals unable to provide behavioral responses. However, it remains unclear whether brainstem or cortical activity better reflects perceptual thresholds, and how stimulus characteristics influence this relationship. This study investigated the agreement between evoked potentials and behavioral thresholds using different stimuli and presentation rates.

Methods: Two experiments examined agreement between AEPs and behavioral thresholds. Experiment 1 (n = 8 ears) used LS CE-Chirp stimuli at 33.3 stimuli/second. Experiment 2 (n = 12 ears) used 1 kHz tone burst stimuli and examined three conditions: behavioral thresholds at 33.3 stimuli/second (Experiment 2a), behavioral thresholds at 1.0 stimuli/second (Experiment 2b), and standard 1 kHz pure tone audiometry (Experiment 2c). Different adult groups (≥18 years) were recruited for each experiment. Behavioral thresholds were obtained via the Hughson-Westlake method. Thresholds were compared using Wilcoxon signed-rank tests.

Results: Agreement patterns varied systematically with stimulus characteristics. For LS CE-Chirp stimuli at 33.3 stimuli/second, ABR thresholds showed significantly better agreement with behavioral thresholds than CAEP thresholds (p < 0.05). For 1 kHz tone burst stimuli at 33.3 stimuli/second, no significant difference was observed between ABR and CAEP agreement with behavioral thresholds (p > 0.05). However, at 1.0 stimuli/second, CAEP thresholds demonstrated significantly better agreement with behavioral thresholds than ABR thresholds (p < 0.05). Both ABR and CAEP thresholds showed comparable agreement with clinical 1 kHz pure tone audiometry thresholds (p > 0.05).

Conclusion: These preliminary findings demonstrate that both stimulus type and presentation rate influence threshold estimation, with slower rates favoring cortical-behavioral agreement and faster rates favoring brainstem-behavioral agreement. These context-dependent patterns may guide measurement strategies and support their use in the identification of auditory dysfunction. Further research with larger samples is needed to validate these findings and establish their clinical applicability.

Introduction: Vestibular rehabilitation therapy (VRT) has demonstrated effectiveness in adults; however, evidence supporting its use in children remains limited. Given the potential developmental impacts of vestibular-related problems, it is essential to identify accessible and age-appropriate strategies for targeted rehabilitation in pediatric populations. In Malaysia, access to physical therapists trained in vestibular rehabilitation for children is limited, and logistical barriers often hinder regular clinic attendance. These challenges underscore the need for a home-based alternative.

Objective: This study aimed to adapt and evaluate the feasibility of a home-based video exercise program (HBVEP) for children aged 7 to 12 years old.

Results: The structured feasibility questionnaire revealed strong parental endorsement, with most responses ranging from "agree" to "completely agree" regarding the exercise program's acceptability, appropriateness, and feasibility. Completion time data indicated that the exercises were manageable, and analysis of exercise preferences offered insight into which components were most engaging for children and parents.

Conclusion: The results support the practicality of the HBVEP as a targeted rehabilitation approach for school-aged children. It offers a flexible, low-cost alternative to in-clinic therapy. However, further research involving children with vestibular and balance impairments is needed to assess the full clinical utility and effectiveness of this intervention.

The device-oriented subjective outcome (DOSO) was originally designed to evaluate hearing aid performance in terms of communication ease, satisfaction, and listening effort. It underwent review by a panel of eight experts from audiology and related disciplines. The Malay version of the DOSO scale was assessed for content validity, face validity, and reliability to confirm its cultural appropriateness and precision in evaluating hearing aid outcomes among Malaysian users. Fifteen items were revised to improve clarity based on the expert's feedback. Face validity testing was conducted with 33 experienced hearing aid users, and test-retest reliability was evaluated using seven participants. The content validity analysis revealed a high item-level Content Validity Index (CVI) ranging from 0.62 to 1.00, alongside a robust overall Scale-Level Content Validity Index/Average (S-CVI/Ave) of 0.90. Face validity scores (I-FVI: 0.67-1.00; S-FVI/Ave: 0.88) and a comprehension clarity score of 0.86 suggest that the tool was effectively understood. Cronbach's α values varied between 0.77 and 1.00, indicating good to excellent internal consistency. The validated Malay DOSO serves as a reliable tool for assessing hearing aid outcomes, thereby endorsing its use in both clinical and community contexts in Malaysia. Additional research involving a more diverse population is recommended to improve generalizability.

This editorial summarizes the 7th Malaysian Audiology Scientific Conference (MASCO) 2025, held in Penang, Malaysia, under the theme "Building Strong Foundations: The Evolution of Evidence-Based Practice in Audiology." The conference gathered 111 audiologists and 26 students, featuring six plenary sessions by international and local experts on translational practice, auditory processing disorder, tinnitus management, and pediatric hearing loss. Participants presented 14 oral papers, 15 three-minute pitches, and 23 e-posters showcasing innovative diagnostic tools and clinical applications. MASCO 2025 emphasized bridging research and practice through interdisciplinary collaboration and localized strategies to advance audiology service delivery in Malaysia.

This preliminary study benchmarks audiovestibular practices among audiologists in Asia-Pacific (APAC) countries with established professional training programs, forming the first phase of a broader initiative covering 17 nations. A structured questionnaire was adapted and updated to include contemporary clinical domains such as vestibular rehabilitation, cochlear implant services, and tele-audiology. The tool underwent expert review and pilot testing, demonstrating strong psychometric properties (Cronbach's α, α = 0.91; KMO = 0.743; Bartlett's p  < 0.001). Responses were obtained from 40 audiologists across India, Malaysia, Singapore, Nepal, and New Zealand. Most participants provided services across screening, diagnostic, therapeutic, and rehabilitative domains. Core procedures such as immittance testing, otoacoustic emissions, and auditory brainstem response were widely implemented, while vestibular and rehabilitative services showed increasing integration. Respondents represented diverse professional contexts, including universities, private hospitals, and government healthcare systems. Notably, there was strong professional consensus in support of regional standardization of guidelines, training, and governance mechanisms. These findings validate the adapted tool, establish a foundational dataset, and highlight readiness for regional collaboration. As the broader 17-country study advances, this work provides a baseline for benchmarking, policy development, and capacity building toward harmonized audiovestibular care across the APAC region.

Inner ear malformations (IEMs) represent unique challenges in cochlear implantation, potentially influencing electrode placement during surgery and neural responsiveness. Thus, electrically evoked cortical auditory potentials (eCAEPs) were suggested to be performed as objective measures of higher-level auditory perception at the cortical level in assessing cochlear implant (CI) outcomes in this complex population. This study aims to evaluate preliminary findings of P1 latency in eCAEPs among CI recipients with several types of IEMs at different positions of electrodes, that is, apical, medial, and basal regions. A cohort of five CI recipients with IEMs was evaluated using postoperative eCAEPs recordings, and P1 latency was analyzed at different positions of electrodes. The mean age of the subjects was 14.01 ± 5.51 years, with common cavity malformations, incomplete partition type I (IP-I), incomplete partition type II (IP-II), and enlarged vestibular aqueduct. Early data suggest P1 responses were generally present in all IEM cases in this cohort, with the mean of P1 latency for the electrode at apical, medial, and basal regions of 108.2 ± 13.4, 124.0 ± 23.6, and 140.0 ± 41.5 ms, respectively. These findings may reflect differential cortical response across IEM types at multiple CI electrode locations.