Ear and Hearing最新文献

Objectives: Otitis media (OM) is among the most common childhood diseases. Many studies have suggested that recurrent OM episodes during early childhood can have long-lasting adverse effects on essentially every level of the auditory system. However, the literature on this topic is heterogeneous and results are mixed. Hence, a need exists to structure the available evidence. Here, a scoping review was conducted, aiming to (1) map the many different outcome measures used to assess the long-term impact of OM, (2) appraise the quality of the available OM documentation, and (3) provide a summary of the available evidence and its potential link with OM documentation.

Design: Original articles were identified through systematic searches in the PubMed, Embase, and Cochrane Library databases. To be included, studies were required to assess the long-term impact of resolved early childhood OM on hearing abilities. Two reviewers independently screened studies for inclusion. A data charting form, developed by author LVY, was used to extract information about the publication (year, journal, country of data collection) and study characteristics (sample size, outcome measures, OM documentation).

Results: The search identified 16,267 records, out of which 94 articles were included. Most of the current evidence is based on retrospective data from high-income countries, using a wide range of outcome measures. The retrospective study design poses challenges for thorough OM documentation, especially regarding OM history of the controls. A narrative synthesis showed consistently elevated audiometric thresholds in the extended high-frequency range and poorer gap detection abilities in children with a history of early childhood OM. Mixed results were found in terms of speech perception and binaural unmasking.

Conclusions: This scoping review demonstrates the breadth of the literature on this topic. A wide range of outcome measures have been used, and the quality of OM documentation varies greatly across studies. Variability of the literature results may-at least to some extent-be explained by inadequate OM documentation, recruitment bias, and variability in the time since the last OM episode. Recommendations for future research are provided.

Objectives: Age-related hearing loss, the predominant global cause of hearing loss in middle-aged and older adults, presents a significant health and social problem, particularly affecting speech understanding. Beyond the auditory system, cognitive functions play a crucial role in speech understanding, especially in noisy environments. Although visual cognitive testing is commonly used as an intriguing alternative to mitigate the potential adverse effects of hearing loss on the perception of auditory test items, its efficacy within a hearing-related context is questionable due to construct differences. Therefore, this study aims to investigate the construct validity of auditory and visual versions of cognitive tests in predicting speech understanding, to identify the best suitable auditory or visual cognitive predictor(s) for implementation in the field of audiology.

Design: Fifty-two middle-aged and older adults with normal hearing and 52 with hearing loss were included in the study (mean age for the total group: 67.38 years [SD: 7.71 years], range: 45 to 80 years). Both subgroups were matched based on age, sex, and educational level. Speech understanding in quiet (SPIQ) and in noise (SPIN) was assessed using the ecologically valid Dutch Linguistically Controlled Sentences test. An extensive cognitive test battery was assembled, encompassing measures of sustained attention, working memory, processing speed, and cognitive flexibility and inhibition, through both auditory and visual assessments. Correlation coefficients examined the relationship between the independent variables (demographics and cognition), and SPIQ and SPIN separately. Identified predictors underwent stepwise and hierarchical multiple regression analyses, with significant variables included in final multiple regression models for SPIQ and SPIN separately.

Results: The final multiple regression models demonstrated statistically significant predictions for SPIQ (adjusted R2 = 0.699) and SPIN (adjusted R2 = 0.776). Audiometric hearing status and auditory working memory significantly contributed to predicting SPIQ, while age, educational level, audiometric hearing status, auditory sustained attention, and auditory working memory played significant roles in predicting SPIN.

Conclusions: This study underscores the necessity of exploring construct validity of cognitive tests within audiological research. The findings advocate for the superiority of auditory cognitive tests over visual testing in relation to speech understanding.

Objectives: The auditory brainstem response (ABR) is an evoked potential used to estimate the hearing thresholds and identify potential auditory pathologies. Although a click stimulus is generally used as an auditory stimulus in diagnostics, recent reports show that the Level-Specific CE-Chirp (LS CE-Chirp) stimulus can also be used for clinical diagnosis. In this study, we compared the auditory brainstem test outcomes of the LS CE-Chirp stimulus and the click stimulus in individuals with high-frequency hearing loss (HFHL).

Design: Patients with HFHL (n = 30) and individuals with normal hearing (n = 30) were included in the study. Audiometric pure-tone thresholds were determined for all subjects at 250 to 8000 Hz. For individuals with normal hearing, the pure-tone thresholds were required to be ≤20 dB HL for all frequencies. HFHL cases were selected from people with at least 5 years of hunting experience. All subjects were tested with ABR at 80 and 60 dB nHL. The ABR test was performed using click and LS CE-Chirp stimuli at a rate of 11.1/sec. ABR wave I, III, and V peak latencies and I to V interpeak latency values were compared within and among the groups.

Results: Longer latency values were obtained with the LS CE-Chirp stimulus at 80 dB nHL intensity and 11.1/sec stimulus frequency than with the click stimulus in the control group. No significant difference was detected between the LS CE-Chirp and click stimuli at the 80 dB nHL intensity level in the HFHL group ( p > 0.005). When the HFHL patients were classified according to the 4000 Hz threshold, the click stimulus was found to be more compatible with the behavioral 4000 Hz threshold.

Conclusions: The wave latency values obtained with the LS CE-Chirp stimulus in the HFHL group, unlike with the click stimulation, were less affected by the level of hearing loss in the HFHL group. For this difference to have a diagnostic value, further studies would be needed on patients with different pathologies and hearing loss configurations.

Objectives: To examine the effects of distractor sounds presented to the contralateral ear on speech intelligibility in patients with listening difficulties without apparent peripheral pathology and in control participants.

Design: This study examined and analyzed 15 control participants (age range, 22 to 30 years) without any complaints of listening difficulties and 15 patients (age range, 15 to 33 years) diagnosed as having listening difficulties without apparent peripheral pathology in the outpatient clinic of the Department of Otolaryngology-Head and Neck Surgery, Tohoku University Hospital. Speech intelligibility for 50 Japanese monosyllables presented to the right ear was examined under the following three different conditions: "without contralateral sound," "with continuous white noise in the contralateral ear," and "with music stimuli in the contralateral ear."

Results: The results indicated the following: (1) speech intelligibility was significantly worse in the patient group with contralateral music stimuli and noise stimuli; (2) speech intelligibility was significantly worse with contralateral music stimuli than with contralateral noise stimuli in the patient group; (3) there was no significant difference in speech intelligibility among three contralateral masking conditions (without contra-stimuli, with contra-noise, and with contra-music) in the control group, although average and median values of speech intelligibility tended to be worse with contralateral music stimuli than without contralateral stimuli.

Conclusions: Significantly larger masking effects due to a contralateral distractor sound observed in patients with listening difficulties without apparent peripheral pathology may suggest the possible involvement of masking mechanisms other than the energetic masking mechanism occurring in the periphery in these patients. In addition, it was also shown that the masking effect is more pronounced with real environmental sounds, that is, music with lyrics, than with continuous steady noise, which is often used as a masker for speech-in-noise testing in clinical trials. In other words, it should be noted that a speech-in-noise test using such steady noise may underestimate the degree of listening problems of patients with listening difficulties in their daily lives, and a speech-in-noise test using a masker such as music and/or speech sounds could make listening problems more obvious in patients with listening difficulties.

Objectives: A growing body of evidence has linked vestibular function to the higher-order cognitive ability in aging individuals. Past evidence has suggested unique links between vestibular function and cognition on the basis of end-organ involvement (i.e., otoliths versus canals). However, past studies have only assessed vestibular reflexes despite the diversity of vestibular pathways. Thus, this exploratory study aimed to assess associations between vestibular perception and cognition in aging adults to determine potential relationships.

Design: Fifty adults (21 to 84 years; mean = 52.9, SD = 19.8) were included in this cross-sectional study. All participants completed a vestibular perceptual threshold test battery designed to target perception predominantly mediated by each end-organ pair and intra-vestibular integration: 1 Hz y -translation (utricle), 1 Hz z -translation (saccule), 2 Hz yaw rotation (horizontal canals), 2 Hz right anterior, left posterior (RALP), and left anterior, right posterior (LARP) tilts (vertical canals), and 0.5 Hz roll tilt (canal-otolith integration). Participants also completed standard assessments of cognition and path integration: Digit Symbol Substitution Test (DSST), Trail Making Test (TMT), and the Gait Disorientation Test (GDT). Associations were assessed using Spearman rank correlation, and multivariable regression analyses.

Results: For correlation analyses, DSST correlated to RALP/LARP tilt, roll tilt, and z -translation. TMT-A only correlated to z -translation, and TMT-B correlated to roll tilt and z -translation after correcting for multiple comparisons. GDT correlated to RALP/LARP tilt and y -translation. In age-adjusted regression analyses, DSST and TMT-B were associated with z -translation thresholds and GDT was associated with y -translation thresholds.

Conclusions: In this cross-sectional study, we identified associations between vestibular perceptual thresholds with otolith contributions and standard measures of cognition. These results are in line with past results suggesting unique associations between otolith function and cognitive performance.

Objectives: Older adults use semantic context to generate predictions in speech processing, compensating for aging-related sensory and cognitive changes. This study aimed to gauge aging-related changes in effort exertion related to context use.

Design: The study revisited data from Harel-Arbeli et al. (2023) that used a "visual-world" eye-tracking paradigm. Data on efficiency of context use (response latency and the probability to gaze at the target before hearing it) and effort exertion (pupil dilation) were extracted from a subset of 14 young adults (21 to 27 years old) and 13 older adults (65 to 79 years old).

Results: Both age groups showed a similar pattern of context benefits for response latency and target word predictions, however only the older adults group showed overall increased pupil dilation when listening to context sentences.

Conclusions: Older adults' efficient use of spoken semantic context appears to come at a cost of increased effort exertion.

Objectives: The present study aimed to examine the involvement of listening effort among multilinguals in their first (L1) and second (L2) languages in quiet and noisy listening conditions and investigate how the presence of a constraining context within sentences influences listening effort.

Design: A group of 46 young adult Arabic (L1)-Hebrew (L2) multilinguals participated in a listening task. This task aimed to assess participants' perceptual performance and the effort they exert (as measured through pupillometry) while listening to single words and sentences presented in their L1 and L2, in quiet and noisy environments (signal to noise ratio = 0 dB).

Results: Listening in quiet was easier than in noise, supported by both perceptual and pupillometry results. Perceptually, multilinguals performed similarly and reached ceiling levels in both languages in quiet. However, under noisy conditions, perceptual accuracy was significantly lower in L2, especially when processing sentences. Critically, pupil dilation was larger and more prolonged when listening to L2 than L1 stimuli. This difference was observed even in the quiet condition. Contextual support resulted in better perceptual performance of high-predictability sentences compared with low-predictability sentences, but only in L1 under noisy conditions. In L2, pupillometry showed increased effort when listening to high-predictability sentences compared with low-predictability sentences, but this increased effort did not lead to better understanding. In fact, in noise, speech perception was lower in high-predictability L2 sentences compared with low-predictability ones.

Conclusions: The findings underscore the importance of examining listening effort in multilingual speech processing and suggest that increased effort may be present in multilingual's L2 within clinical and educational settings.

Objectives: The purpose of this study was to evaluate threshold and suprathreshold auditory risk from a newly popular platform of music concert entertainment; virtual reality (VR) headsets. Recreational noise exposure to music is the primary source of hearing hazard in young-adults, with noise doses of in-person concert venues and music festivals well in excess of the recommended daily exposure recommendation from the National Institute for Occupational Safety and Health. While research on the relationship between personal music players and noise-induced hearing loss risk is abundant, no study has yet evaluated noise-induced hearing loss risk from VR headsets, which are newest to the commercial market at this time.

Design: Thirty-one young-adult participants (18 to 25 years) with normal-hearing sensitivity (0 to 16 dB HL) experienced a VR music concert and participated in three data collection timepoints: Session A preexposure, Session A post-exposure, and Session B post-exposure. Participants underwent baseline testing for audiometry (0.25 to 20 kHz), distortion product otoacoustic emission testing (1 to 10 kHz), and Words-in-Noise testing. Participants then wore a commercially available VR headset (Meta Quest 2) and experienced a freely available online VR music concert (via the video-sharing website "YouTube"). The VR music concert duration was 90 min set to maximum volume, which yielded an average sound level equivalent of 78.7 dBA, max sound level of 88.2 dBA, and LC peak sound level of 98.6 dBA. Post-exposure testing was conducted immediately at the conclusion of the VR concert, and again within 24 hr to 1 week after the exposure. Participants also answered a questionnaire that estimated noise exposure history (National Acoustics Laboratory "Noise Calculator").

Results: Post-exposure deficit was not observed in DPOAEs or Words-in-Noise score ( p' s > 0.05). However, statistically significant temporary post-exposure deficit was observed in audiometry at 4, 8, and 12.5 kHz ( p 's < 0.05) (mean differences: 2 to 3 dB HL). Twenty-four hours and 1-week post-exposure measurements revealed no permanent changes from baseline measurements ( p 's > 0.05) aside from one spurious difference at 12.5 kHz. Males tended to exhibit a significantly higher noise history score on average than females. The primary, secondary, and tertiary sources of noise hazard history in this young-adult cohort included amplified music.

Conclusions: These preliminary data suggest that VR music concerts-which are likely to produce a substantially lower noise dose than in-person music concerts-may still be capable of producing at least slight, temporary threshold shifts on the order of 2 to 3 dB HL. Future research should include VR headsets in personal music player risk assessment, as the VR music concert platform is increasing rapidly in popularity among young-adults.

The ability to monitor surrounding natural sounds and scenes is important for performing many activities in daily life and for overall well-being. Yet, unlike speech, perception of natural sounds and scenes is relatively understudied in relation to hearing loss, despite the documented restorative health effects. We present data from first-time hearing aid users describing "rediscovered" natural sounds they could now perceive with clarity. These data suggest that hearing loss not only diminishes recognition of natural sounds, but also limits people's awareness of the richness of their environment, thus limiting their connection to it. Little is presently known about the extent hearing aids can restore the perception of abundance, clarity, or intensity of natural sounds. Our call to action outlines specific steps to improve the experience of natural sounds and scenes for people with hearing loss-an overlooked aspect of their quality of life.