Audiology and Neuro-Otology最新文献

Introduction: This study investigates whether high levels of headphone music listening in young adults contribute to hidden hearing loss (HHL) and whether listening effort (LE) and cognitive skills differ based on headphone exposure.

Methods: Fifty participants (18-30 years) with normal hearing were divided into high-risk (HR) and low-risk (LR) groups based on annual headphone exposure levels recorded via smartphone applications. Participants underwent high-frequency audiometry, auditory brainstem response (ABR), matrix sentence test, behavioral LE measurement, and P300 testing. The measurement of LE and P300 was conducted at varying signal-to-noise ratio (SNR). Working memory was assessed using the reading span test, while attention abilities were evaluated with the Stroop test. Finally, short-term memory was assessed through the visual auditory number sequences test.

Results: The findings from the ABR and matrix sentence tests indicated signs of noise-induced cochlear synaptopathy in the HR group. In this group, an increase in LE was observed as SNR decreased, which was statistically significant. Furthermore, a significant decrease in P300 amplitude was found in response to SNR changes in the HR group; however, no significant difference was observed in the LR group. Statistical analysis revealed no significant differences between the two groups in the cognitive tests administered.

Conclusions: The present study lends support to the hypothesis that the habitual listening of music at high volumes through headphones has the potential to result in HHL; however, further longitudinal studies are required to assess the impact of this condition on cognitive skills.

Introduction: The floating mass transducer (FMT) of the Vibrant Soundbridge (VSB) is successfully used for reverse stimulation of the round window membrane (RWM) since 2005, enabling the treatment of conductive and mixed hearing loss. The FMT can be placed directly to the RWM or indirectly by using an interposed material such as fascia and Tutopatch, or a coupler, e.g., the round window coupler (RWC), the round window soft (RWS) coupler, or the custom-made Hannover coupler version 2 (HCV2). The aim of the study was to retrospectively evaluate the long-term outcome of the most common VSB round window (RW) coupling modalities in our clinic with regard to (1) safety and preservation of residual hearing, (2) coupling efficiency (C_eff), and (3) speech outcome.

Methods: A total of 111 RW vibroplasties, a surgical procedure including the implantation of the VSB, in 102 ears (95 patients) performed at the Hannover Medical School between 2006 and 2021 were analyzed. Seventy-nine RW vibroplasties in ears with available preoperative bone conduction pure tone average (BC PTA₄) were included in the safety analysis, focusing on adverse events (AEs). Furthermore, the audiological outcomes were evaluated in 56 ears (52 patients, 4 bilateral implanted) preoperatively, at initial activation (6-8 weeks), 2 years, and 5 years, including BC PTA₄ (at 0.5, 1, 2, 4 kHz), C_eff (in situ measurement - BC PTA₄), effective gain (BC PTA₄ - sound field threshold), and monosyllable word recognition score (WRS; Freiburg monosyllable test at 65 dB SPL).

Results: The safety analysis showed a total mean AE rate of 29.1%. A statistically significant decline over time in BC PTA₄ was found in groups RWS and HCV2 by 7.6 dB and 8.8 dB (paired t test, p = 0.022 and p ≤ 0.001, respectively), at 2 years. The WRS improved over time in all groups, resulting in an overall mean score of 81.1% in the range 70.0% to 90.8% at 2 years, with a statistically significant improvement between IA and 2 years and the best mean WRS of 90.8% at 2 years in group HCV2 (paired t test, p ≤ 0.001). While the C_eff was stable and below 25 dB at all time points in most groups, it improved statistically significantly in group RWC by a total of 9.9 dB between IA and 5 years to 16.8 dB (paired t test, p ≤ 0.001).

Conclusion: The RW vibroplasty is a safe surgery, though complex and challenging. All investigated coupling modalities provided effective treatment for conductive and mixed hearing loss. Patients in group RWC and HCV2 tended to perform noticeably better in terms of aided speech understanding and C_eff than those in the other groups.

Introduction: Emotional response to music, though a central facet of music listening, remains poorly understood. In this study, we investigate the emotional responses to music among bilateral cochlear implantees.

Methods: Bilateral CI users and normal-hearing (NH) controls were recruited from a tertiary academic center and community hearing loss groups. Participants listened (via an online survey) to ten previously validated 15-s musical clips representing multiple genres and wide range of valence (happiness vs. sadness) and arousal (excitement vs. calm) and rated the musical clips on validated nine-point visual analog scales of valence and arousal.

Results: In total, 25 bilateral CI users and 18 NH controls completed the study. Compared to NH controls, CI users demonstrated significantly increased error in valence identification (mean [SD] 1.75 [0.61] vs. 1.16 [0.29], p < 0.001) but equivalent arousal error. There were significant differences for 8 of 20 total ratings between NH and CI groups. Additionally, CI users demonstrated a significantly constricted range of arousal (4.69 [1.39] vs. 6.04 [1.33], p = 0.0025) but a preserved range of valence (4.99 [1.57] vs. 5.62 [1.13], p = 0.13). Implantees reported significantly lower music enjoyment (5.78 [3.57] vs. 8.57 [1.17], p = 0.0016) than NH controls, and enjoyment was significantly associated with both valence and arousal range.

Conclusions: Bilateral CI users' emotional response to music is significantly constricted compared to NH controls. Blunted appreciation of emotional content likely contributes to reduced music enjoyment among cochlear implantees and is a critical target for improvement.

Introduction: For a comprehensive approach in children with hearing loss (HL), some cognitive and language skills should also be considered, along with auditory skills. The main aim of this study was to evaluate the working memory and language skills in children with mild to moderate HL.

Methods: Forty children with mild to moderate HL between the ages of 4 and 9 years were included in this study. The children with mild and moderate HL were evaluated in two groups. The Meaningless Word Repetition test, Test of Language Development-Primary test, and Meaningful Auditory Integration Scale were administered to assess working memory, language skills, and auditory perception, respectively. Also, the relationship between language and memory skills was evaluated.

Results: The study found statistically significant correlations between language skills and working memory test scores. Additionally, statistically significant differences were found between children with mild and moderate HL in terms of language and memory skills (p < 0.001).

Conclusion: The children with moderate HL demonstrated poorer performance compared to those with mild HL. Even if it is mild, the degree of HL affects children's language and memory skills. It is emphasized that the relationship between language and working memory should be taken into consideration in auditory rehabilitation programs for these children.

Introduction: Tinnitus, the perception of sound without an external auditory stimulus, affects approximately 10-15% of the population and is often associated with significant comorbidities such as headaches. These conditions can severely impact the quality of life. The aim of this study was to evaluate the efficacy of a food supplement in reducing the symptoms of both tinnitus and headache in patients experiencing these conditions concurrently.

Methods: This prospective study included 32 patients (21 males and 11 females) aged between 23 and 68 years (mean age 49.38 years) who were experiencing both tinnitus and headache. The study assessed the impact of a food supplement on tinnitus and headache over a 90-day treatment period using three main instruments: the Tinnitus Handicap Inventory (THI), the Headache Impact Test (HIT-6), and a Visual Analog Scale (VAS) for discomfort. Statistical analyses, including paired t tests, were conducted to compare pre- and posttreatment scores. In the same dataset, Ridge Regression, a linear regression model with L2 regularization, was used to predict posttreatment scores (THI90, HIT90, VAS90).

Results: The results indicated a statistically significant reduction in all three measures after 90 days of treatment. The mean THI score decreased from 29.81 to 27.06 (p = 0.011), the mean HIT-6 score decreased from 50.41 to 48.75 (p = 0.019), and the mean VAS score for discomfort decreased from 7.63 to 7.13 (p = 0.033). The optimal Ridge Regression model was found with an "alpha" value of approximately 3.73. The performance metrics on the test set were as follows: Mean Squared Error (MSE) of 13.91 and an R-squared score of 0.61, indicating that the model explains approximately 61% of the variance in the posttreatment scores. These results indicate that pretreatment scores are significant predictors of posttreatment outcomes, and gender plays a notable role in predicting HIT and VAS scores posttreatment.

Conclusion: This study demonstrates that a food supplement is effective in reducing the symptoms of tinnitus and headache in patients suffering from both conditions. The significant improvements in THI, HIT-6, and VAS scores indicate a positive impact on patient quality of life. Further research with larger sample sizes and more detailed subgroup analyses is recommended to fully understand the differential impacts of treatment across various demographics.

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.

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: 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: 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: 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.