Audiology and Neuro-Otology最新文献

Objective: This study seeks to assess the prevalence of hearing difficulties and hearing healthcare system utilization among English-speaking migrants living in Thailand.

Design, setting, and participants: A cross-sectional survey was digitally distributed to online forums and communities for English-speaking migrants living in Thailand. Ninety participants were included in the study.

Results: Seventy-seven percent of men and 75.8% of women reported at least some hearing difficulty. People who reported hearing loss were more likely to be white, and people who reported greater social disruption due to hearing difficulty were more likely to be younger or transgender. Though people with more hearing loss had received hearing testing more recently than peers with less hearing loss, very few participants treated their hearing loss with hearing aids and no participants received their hearing healthcare services in Thailand.

Conclusion and relevance: This study shows that English speaking migrants living in Thailand may have hearing difficulty and low rates of hearing healthcare utilization. These results highlight the need for additional research to understand the hearing healthcare needs of this population.

Introduction: This study investigates factors that relate to long-term educational and occupational outcomes of adults who received cochlear implants (CIs) during childhood.

Methods: A retrospective chart review was conducted on 109 adults who received a CI before the age of 15 between 2000 and 2012 at a US tertiary medical center. Demographic variables, speech perception scores, and educational and vocational achievements were analyzed. Current US Census and Bureau of Labor Statistics data were used for comparison.

Results: The median age at implantation was 2.81 years, and the median age at data collection was 27.30 years. Most subjects were unilaterally implanted (63.3%) and used an oral communication approach (89.0%). Educational outcomes showed that 17% completed a high school diploma or less, and 9% completed an associates or technical degree. Seventy-two percent of the subjects achieved a bachelor's degree or higher, significantly higher than the general US population (37.9%). Occupational outcomes indicated that subjects were employed across various job categories, with a higher proportion in jobs requiring considerable preparation (job zone 4) compared to the general population. There was a significant negative correlation between age at implantation and speech perception scores. Better word recognition scores were also associated with better educational and occupational outcomes.

Conclusions: Adults who received CIs as children demonstrate excellent educational and occupational outcomes, surpassing those of the general US population. Early implantation and the absence of additional disabilities positively influence these outcomes. Continued investigation of nonspeech outcomes and the factors that influence them is essential to provide better support services for future cohorts.

Introduction: Dichotic listening (DL) is a test where auditory stimuli are presented simultaneously to each ear. DL has clinical applications in assessing APD, schizophrenia, and brain injury. It is sensitive to hemisphere differences and has been used to study language lateralization. The study aimed to develop, validate, and establish norms for a Quadri condition Dichotic Double Word Test (free recall, forced right, forced left, and switch attention) in the Kannada language (DDWT-K).

Methods: This study was carried out in two phases. Phase 1 aimed to develop and validate the DDWT-K and phase 2 involved data collection. The developed novel dichotic test was administered on 100 normal-hearing adults in four conditions - free recall, forced right, forced left, and switch attention.

Results: The results showed significant ear differences in free recall condition indicating right ear advantage. The switch attention condition showed slightly poorer performance when compared to both the forced attention condition indicating greater task difficulty. The test-retest reliability was above 0.7 for all the conditions indicating good reliability.

Conclusions: The findings demonstrated the best preservation of the original dichotic effects and hence ready for clinical use.

Introduction: Patients with migraine may be more susceptible to benign paroxysmal positional vertigo (BPPV) than the general population. Although the underlying pathophysiology remains uncertain, it has been postulated that recurrent vasospasms associated with migraine attacks may cause inner ear ischemia and changes in endolymph pressure. Currently, there are no specific recommendations for preventing BPPV in this vulnerable patient population. Among commonly used migraine abortive drugs, triptans, which are selective serotonin agonists, are known to be vasoconstrictive, whereas calcitonin gene-related peptide (CGRP) antagonists are not. This population-based study uses a federated electronic medical record (EMR) database to characterize the prevalence of BPPV among migraine patients and its relevance to their choice of abortive drug.

Methods: In this case-control study, EMR data from the TriNetX US Collaborative Network were queried for subjects who were seen at a participating healthcare organization for a vestibular disorder (ICD10: H81) between 2019 and 2024. Subjects must also have a concomitant, pre-existing diagnosis of migraine (G43). These patients were stratified by age (18-44, 45-64, 65+ years) and sex. The resulting cohorts were then divided into those with and without a BPPV diagnosis (H81.1). Patients with prior documented head trauma (S02, S06, S09), middle or inner ear surgery, or vitamin D deficiency (E55) were excluded. The prevalence of pre-existing triptan and CGRP antagonist use of each BPPV cohort was compared against the non-BPPV cohort of the same age and sex using χ2 analysis.

Results: As expected, the female subject population had significantly higher prevalence of migraine (17.06% vs. 7.26%, p < 0.0001) than the males. Among migraine patients of all ages and sexes, triptan use was significantly more common among BPPV patients than non-BPPV patients (30.90% vs. 25.35%, p < 0.0001). Conversely, CGRP antagonists were more commonly used by non-BPPV patients than by BPPV patients (3.17% vs. 2.45%, p = 0.0005).

Conclusion: This study shows that, among patients with vestibular disorders, migraine patients with BPPV are more often exposed to triptans, and less to CGRP antagonists, than those without BPPV. Triptans may increase the prevalence of BPPV by potentiating vasoconstriction during migraine attacks, which may result in inner ear ischemia and alterations of endolymphatic pressure, while CGRP antagonists do not. Therefore, CGRP antagonists may be preferable over triptans for preventing BPPV in migraine patients.

Introduction: The Epley maneuver is the recommended treatment for benign paroxysmal positional vertigo of the posterior semicircular canal (PC-BPPV). Traditionally, the angle of the patient's head in each position during the Epley maneuver is not monitored and subjectively estimated by physicians. As a result, deviations of head angles from the standard may affect the treatment result. This study aimed to compare the outcome of the Epley maneuver between the group of exact head angles and the group of subjectively estimated angles (traditional Epley maneuver).

Methods: A single-blind randomized controlled trial was conducted at the Department of Otolaryngology, Chiang Mai University Hospital. PC-BPPV patients were attached with the head angle measuring device and randomized into 2 groups: group I - the exact angle group, physicians performed the Epley maneuver with accurate head angle in each step; and group II - the estimated angle group, physicians performed the Epley maneuver by estimating the head angle (traditional Epley maneuver). The treatment outcomes were measured at 1 week in the aspects of negative Dix Hallpike results and severity of dizziness.

Results: Thirty-one PC-BPPV patients were recruited and randomized into group I (15 participants) and group II (16 participants). Both groups showed clinical improvement. Although significant deviations of head angles were observed in group II, there was no significant difference in outcomes between the two groups in terms of negative Dix Hallpike and severity of dizziness at the 1-week follow-up.

Conclusions: Although significant variations of head angles were observed during the traditional Epley maneuver by experienced physicians, these deviations were slight (less than 15°) and did not significantly affect the successful treatment outcome at 1 week, in terms of negative Dix Hallpike and severity of dizziness, when compared to the group with accurate head angle during the Epley maneuver.

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.

Purpose: Epidemiological studies have demonstrated a relationship between general intelligence (GI) in youth and hearing loss (HL). However, no large-scale study assessed the relations of GI in late adolescence with conductive HL (CHL) and sensorineural HL (SNHL), stratified by severity. This study examined the connection between HL and GI in late adolescence.

Methods: Cross-sectional study on mandatory premilitary recruitment data recorded during 1967-2019 of patients aged 17-19. We compared GI between SNHL, CHL, and those with normal hearing. In addition, we used logistic regression to measure the associations between HL and GI after adjuring for age, sex, education, and socioeconomic status.

Results: Among 3,104,851 adolescents assessed, 20,075 (0.6%) exhibited HL. We categorized GI into three levels for analysis: low (lowest category), medium, and high (reference category). Adjusted odds ratios (ORs) revealed that SNHL was associated with lower GI levels, with ORs ranging from 1.3 (95% confidence interval [CI] 1.4-1.2) for the lowest GI category to 1.1 (95% CI 1.15-0.04) for the medium category. CHL (CHL) also demonstrated significant associations, with ORs from 1.8 (95% CI 1.9-1.6) for the lowest GI level to 1.1 (95% CI 1.2-0.9) for medium. Further analysis revealed a statistically significant, severity-dependent relationship between SNHL and the odds of being in the lowest GI quartile (Q1). Specifically, the ORs for SNHL ranged from 1.2 (95% CI 1.1-1.3) to 1.3 (95% CI 1.1-1.5) as severity increased, indicating a strong link between greater SNHL severity and reduced cognitive performance. In contrast, CHL did not show a consistent correlation between its severity and GI outcomes, with an OR of 1.6 (95% CI 1.2-2.3) across severity levels.

Conclusion: We report a strong relationship between HL and GI in late adolescence. SNHL, but not CHL, demonstrated a severity-based decline in GI. The results highlight the value of early, specifically targeted therapies for HL that consider its etiology and degree.

Introduction: The totally implantable active middle ear implant Esteem® may be considered an effective alternative to conventional hearing aids (cHAs) to manage moderate-to-severe forms of sensorineural hearing loss. This study aimed to provide long-term comparative data of Esteem performances with those achieved by cHA.

Methods: From a total of 46 subjects who received unilateral application of Esteem®, and were followed up over the years, ten underwent an audiological assessment that compared the outcomes with those achieved in the contralateral ear by a cHA, considering the initially symmetric auditory thresholds in both ears. Other than pure tone audiometry and speech audiometry in quiet, the assessment was performed by using the adaptive speech in noise, i.e., Matrix test.

Results: The mean speech intelligibility in quiet shows in the unaided situation a recognition of 50.7% at 71 dBHL, 71% at 69 dBHL with only contralateral cHA, 92% at 66 dBHL with only Esteem device and 94% at 61 dBHL with Esteem® device and contralateral cHA. The mean speech intelligibility in noise shows in the unaided situation a recognition of 36% at 71 dBHL, 56% at 69 dBHL with only contralateral cHA, 79% at 66 dBHL with only Esteem® device and 84% at 61 dBHL with Esteem® device and contralateral cHA. At Matrix test in the unaided condition, 4 patients reached 50% of intelligibility and the 50% threshold was obtained with a mean sound/noise ratio of +10 dBHL. In the contralaterally aided condition, 10 patients reached a 50% threshold in a condition of mean S/N ratio of +10.6 dBHL. In the Esteem® only and Esteem® plus cHA condition, all patients reached the 50% threshold with a mean S/N ratio of +3.4 dBHL with the Esteem® device and +0.92 dBHL with Esteem® plus a contralateral cHA, with a statistically nonsignificant difference. The mean deviation from the reference value (7.1 dB in the normal hearing population) was 17.1 dBHL, in unaided situation; this condition did not change with only the contralateral cHA (17.6 dBHL), whilst a significant improvement could be identified with only Esteem® device, where the mean deviation was 10.5 dBHL, and mostly with Esteem® device associated with the contralateral cHA, with a value of 8.02 dBHL.

Conclusions: The adaptive speech audiometry in noise (Matrix Test) showed that binaural stimulation provides greater benefits in the speech recognition in noise test in comparison to monaural stimulation, especially when this is carried out only by the cHA. However, the Esteem® device allowed to obtain audiological benefits that are significantly superior to those offered by cHAs, especially in cases where the hearing loss is severe and, in some cases, profound, achieving performances almost comparable to those of a cochlear implant.

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.

Introduction: Positive effects of hearing aids (HA) have been suggested. However, their impact on gait performance, which is closely associated with hearing loss and cognition, remains unclear. This pilot study assessed the impact of wearing HA on gait performance among patients with age-related hearing loss (ARHL).

Methods: This single-arm trial compared gait performance of patients with ARHL before and after wearing HA. Participants diagnosed with ARHL and prescribed HA by an audiologist wore the HA gradually over 1 week. They then underwent a baseline assessment before wearing HA consistently. After wearing the HA for 1 year, participants underwent a follow-up assessment that included evaluations of gait and cognitive performance, fear of falling, incidental falls, and well-being using WHO-5.

Results: Of the 10 participants included, one withdrew during the follow-up period. Intention-to-treat analyses showed improvements in gait step time at both usual and maximum paces due to HA use. Cognitive function, including Montreal Cognitive Assessment scores and delayed verbal recall on the logical memory test, also significantly improved at follow-up. Furthermore, reduced fear of falling and increased WHO-5 scores was observed after 1 year of HA use. Conversely, the rate of incidental falls did not decrease.

Conclusion: HA use may contribute to improved gait performance and reduced anxiety related to physical function, in addition to cognitive function and well-being. Although the results should be interpreted with caution due to the non-randomized controlled trial design and small sample size, the findings suggest that improving hearing acuity among older adults may enhance overall health status.