Audiology and Neuro-Otology最新文献

Introduction: Cochlear implant (CI) users differ greatly in their rehabilitation outcomes, including speech understanding in noise. This variability may be related to brain changes associated with intact senses recruiting cortical areas from stimulation-deprived senses. Numerous studies have demonstrated such cross-modal reorganization in individuals with untreated hearing loss. How it is affected by regular use of hearing devices remains unclear, however. To shed light on this, the current study measured cortical responses reflecting comprehension abilities in experienced CI users and normal-hearing controls.

Methods: Using multichannel electroencephalography, we tested CI users who had used their devices for at least 12 months and closely matched controls (N = 2 × 13). Cortical responses reflecting comprehension abilities - the N400 and late positive complex (LPC) components - were evoked using congruent and incongruent digit-triplet stimuli. The participants' task was to assess digit-triplet congruency by means of timed button presses. All measurements were performed in speech-shaped noise 15 dB above individually measured speech recognition thresholds. Three stimulus presentation modes were used: auditory-only, visual-only, and visual-then-auditory.

Results: The analyses revealed no group differences in the N400 and LPC responses. In terms of response times, the CI users were slower and differentially affected by the three stimulus presentation modes relative to the controls.

Conclusion: Compared to normal-hearing controls, experienced CI users may need more time to comprehend speech in noise. Response times can serve as a proxy for speech comprehension by CI users.

Objectives: The primary goal was to investigate the suitability of CHAPS for assessing cognitive abilities and auditory processing in people with hearing loss (HL), specifically in the domains of auditory processing, verbal working memory, and auditory attention.

Method: The study comprised 44 individuals between the ages of seven and 14, 22 with HL (N = 11 males) and 22 with normal hearing (N = 10 males). Individuals' auditory attention, working memory, and auditory processing skills were assessed in the study, and self-report questionnaires were used. The evaluation utilized the Sustained Auditory Attention Capacity Test (SAACT), Working Memory Scale (WMS), Filtered Words Test, Auditory Figured Ground Test (AFGT), and the Children's Auditory Performance Scale (CHAPS). Analyses were conducted, including group comparisons, correlation examinations, and receiver operating characteristic evaluations.

Results: There were significant differences in CHAPS total, attention, noise, quiet, and multiple inputs between groups. No significant differences were seen in CHAPS_ideal and CHAPS_auditory memory across groups. The study of SAACT and its subscores, WMS and its subscores, FWT, and AFGT revealed a significant difference between groups, caused by the poor performance of persons in the HL group compared to those in the NH group. The SAACT and its subscores correlated significantly with CHAPS_attention. The AUC calculation showed that The SAACT and CHAPS_attention distinguished persons with or without HL (p < 0.05). WMS_STM and WMS_total correlated with CHAPS auditory memory subscale; however, WMS_VWM did not. AUC values for WMS and its subscores showed significant discrimination in identifying children with or without HL (p < 0.05), whereas CHAPS_auditory memory did not (AUC = 0.665; p = 0.060). FWT and AFGT had a significant relationship with CHAPS_noise and CHAPS_multiple inputs subscales. The CHAPS_quiet and CHAPS_ideal subtests only correlated with AFGT. CHAPS_quite and CHAPS_ideal did not exhibit significant discriminative values (p < 0.05) for identifying children with or without HL, while CHAPS_noise, CHAPS_multiple inputs, FWT, and AFGT did.

Conclusion: The CHAPS_attention subscale could be a trustworthy instrument for assessing auditory attention in children with HL. However, the CHAPS_auditory memory subscale may not be suitable for testing working memory. While performance-based auditory processing tests showed improved discrimination, the CHAPS_noise and CHAPS_multiple inputs subtests can still assess hearing-impaired auditory processing. The CHAPS_quiet and CHAPS_ideal subtests may not evaluate auditory processing.

Introduction: Accumulating reports suggest an increase in sudden sensorineural hearing loss during the COVID-19 pandemic and vaccination periods. However, clear evidence is lacking. The goal of this study was to determine if sudden sensorineural hearing loss is associated with COVID-19 illness or its vaccine.

Methods: Retrospective chart review of 50 randomly selected patients from three, 6-month time periods: "pre-pandemic," "early pandemic," and "late pandemic." Group comparisons were performed for demographics, comorbid conditions, audiologic history, audiometric data, speech reception thresholds, and word recognition.

Results: One hundred 50 patients were included in this study. A mean difference was observed in that the relative percentage of sensorineural hearing loss (SNHL) cases increased over time, corresponding to a relative decrease in conductive hearing loss cases. However, this change was not explained by proportional changes in sudden SNHL. Patients in the early pandemic time period were more likely to report tinnitus. Otherwise, the patient groups did not differ on demographic variables, hearing health history, hearing loss presentation, pure tone averages, speech reception thresholds, or word recognition performance.

Conclusions: Proportion of patients with sudden sensorineural hearing loss did not change over time from the pre-pandemic period to the early or late pandemic phases. Despite a randomized sample, these findings do not support the hypothesis that COVID-19 illness or vaccine is associated with sudden sensorineural hearing loss.

Introduction: Hearing loss is a common sensory disorder that impacts patients across the lifespan. Many genetic variants have been identified that contribute to non-syndromic hearing loss. Yet, genetic testing is not routinely administered when hearing loss is diagnosed, particularly in adults. In this study, genetic testing was completed in patients with known hearing loss.

Methods: A total of 104 patients who were evaluated for hearing loss were enrolled and received genetic testing.

Results: Of those 104 patients, 39 had available genetic testing, 20 had one missing allele, and 45 yielded no genetic diagnosis. Of the 39 cases with genetic testing data, 24 were simplex cases, and 15 were multiplex cases. A majority of patients presented with an autosomal recessive inheritance pattern (n = 32), 26 of whom presented with congenital hearing loss. 38% of cases were positive for GJB2 mutation with c.35delG being the most common pathogenic variant. These findings are consistent with previous literature suggesting GJB2 mutations are the most common causes of non-syndromic hearing loss.

Conclusion: Given the frequency of genetic variants in patients with hearing loss, genetic testing should be considered a routine part of the hearing loss work-up, particularly as gene therapies are studied and become more widely available.

Lay summary: Many genetic variants have been identified that contribute to non-syndromic hearing loss. Given the frequency of genetic variants in patients with hearing loss, genetic testing should be considered a routine part of the hearing loss work-up.

Objective: The aim of this study was to evaluate the utility of auditory steady-state responses (ASSRs) to narrow-band chirps (NB-chirps) for estimating hearing levels in children.

Design: Thresholds from the NB-chirp ASSR were evaluated in 30 sedated children with normal hearing or hearing loss. The correlation between the NB-chirp ASSR and pure-tone audiometry (PTA) thresholds was analyzed, and the difference score (DS) between these thresholds was calculated. Data from the NB-chirp ASSR were compared to retrospective data from conventional ASSR to exponentially amplitude-modulated tones in 25 sedated children.

Results: Positive correlations between the NB-chirp ASSR and PTA thresholds were found at 500, 1,000, 2,000, and 4,000 Hz. Multiple comparisons of the DSs for the NB-chirp ASSR and PTA revealed significant differences at 500-2,000 Hz and 4,000 Hz, as well as 1,000-2,000 Hz, and 4,000 Hz. Comparisons of the DSs demonstrated that the DS of the NB-chirp ASSR was significantly smaller than that of the conventional ASSR at 2,000 Hz. Furthermore, the testing times for the NB-chirp ASSR were significantly shorter than those for the conventional ASSR.

Conclusion: The NB-chirp ASSR closely reflected the PTA thresholds, and the testing time was shorter than that of the conventional ASSR. Thus, this study demonstrated that the NB-chirp ASSR is useful for hearing threshold estimation in children.

Objective To develop an algorithm, based on the voltage matrix, for detecting regular cochlear implant (CI) electrode position during the implantation procedure, tip fold-over or basal kinking for lateral-wall electrodes. The availability of an algorithm would be valuable in clinical routine, as incorrect positioning of the electrode array can potentially be recognized intraoperatively. Design In this retrospective study intraoperative voltage matrix and postoperative digital volume tomography of 525 CI recipients were analyzed. On the basis of these data an algorithm was developed for detecting various kinds of electrode misplacements. Results Seven incorrect electrode positions, three tip fold (0.57%) and four basal kinking (0.76%) were detected. For detecting correct positioning, a sensitivity of 99.6%, a specificity of 83.3% and a positive predictive value (PPV) of 99.8% were found. For detecting tip fold-over a sensitivity of 100%, a specificity of 99.8% and a PPV of 75% were found. For detecting basal kinking, a sensitivity of 66%, a specificity of 99.8% and a PPV of 66% were determined. Conclusion The algorithm was found to be an effective screening tool for detecting tip fold-over or basal kinking.

Introduction: To date, no study has reported the various otologic conditions associated with coronavirus disease 2019 (COVID-19) using population-based design. The aim of this study was to investigate the incidence and risk of audio-vestibular disorders (benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus) increasing after COVID-19 infection.

Methods: This retrospective population-based study was conducted using the National Health Insurance Service (NHIS)-COVID-19 cohort database of South Korea. We identified participants in the COVID-19 group using real-time reverse transcription-polymerase chain reaction tests. A matched cohort without COVID-19 was randomly selected in a 1:1 ratio. Benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus were defined using diagnostic, medication, and procedure codes. The incidence and risk of these disorders were assessed in both groups using univariate and multivariate Cox proportional hazard analyses.

Results: In total, 4,976,589 COVID-19 patients and an equivalent number of matched non-infected controls were analyzed. COVID-19 patients faced an increased risk of developing benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus compared to controls in univariate and multivariate Cox hazard analyses. COVID patients were at an increased risk of Meniere's disease in the univariate analysis; however, the risk of Meniere's disease after COVID-19 did not reach statistical significance in the multivariate analysis.

Conclusion: COVID-19 infection may increase the risk of benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus.

Introduction: Research suggests deaf children who receive cochlear implants (CIs) at an early age can achieve age-appropriate language. Recent studies suggest age at full-time CI use is a better predictor of language outcomes than age at implant. The aim of this study was to investigate whether there are correlations between age at implantation, establishing consistent device use, and language outcomes in a cohort of young children in Aotearoa New Zealand.

Methods: A retrospective analysis was conducted. The study included 46 participants, implanted by the Southern Cochlear Implant Programme by age 18 months. The median age at implant was 8 months. Device use was measured via data logging. Consistent device use was defined as ≥8 h per day. Language outcomes were measured at 2- and 3-year post-implantation using PLS-5.

Results: Consistent use was established by 78.3% by 3 years. Language results were at least one SD higher for children who achieved consistent use within 2 years of implant. Language scores for Maori children were more than one SD lower than non-Maori, a finding not entirely explained by less usage. There was no correlation between age of implantation and length of time to consistent device use. The presence of additional disabilities affected consistent device use.

Conclusion: Simply offering CIs earlier is not sufficient to improve language outcomes in the congenitally deaf population. Earlier consistent use was associated with better language outcomes for those implanted before 18 months of age, and language scores were higher for children who achieved consistent use within 2 years of implantation. There is a need to understand why children with pre-lingual deafness may not be achieving consistent device use, and by doing so, we would be a step closer to being able to tailor culturally appropriate supports and services that could help more children achieve better outcomes.

Objective: We investigated the accuracy of imaging modalities in diagnosis and outcome of otitis media with effusion by correlating the imaging findings with the preoperative otomicroscopic examinations, tympanometric results, and intraoperative findings in patients who underwent cochlear implant surgery.

Methods: The results of the preoperative physical examination and intraoperative findings of patients younger than 18 years who underwent cochlear implant surgery at a single tertiary institution were recorded from their medical charts. Tympanometries, which were performed in maximum 1 week prior to imaging modalities, were analyzed. The high resolution computed tomography of temporal bone and magnetic resonance imaging of internal acoustic meati findings were reviewed. The mastoid cavity and middle ears were evaluated separately.

Results: The data comprising of 280 ears were evaluated. The correlation between imaging findings and both physical examination and tympanometries were statistically significant (p = 0.000). The intraoperative findings supported this correlation.

Conclusions: Our study showed that imaging modalities might detect the middle ear and mastoid cavity effusions. The severity of these changes may differ according to the severity of disease.