Audiology and Neuro-Otology最新文献

Introduction: The aims of this study were to measure the effectiveness of hearing aid (HA) fitting in improving understanding in quiet and in noise and to investigate the factors that significantly influence these results. This study will be carried out through a retrospective analysis of the results obtained from patients fitted with HAs at Amplifon HA centers between 2018 and 2021. This study explores and classifies the predictive factors of HAs outcomes, looking at the impact of HA technology, personalized adjustments made by the hearing care professional, and patient follow-up and daily use (data logging).

Methods: The study is based on the analysis of a large population of HA users who were fitted in HA centers between 2018 and 2021. It included 77,661 patients. HA outcome is measured through the improvement of intelligibility in quiet and noise. eXtreme Gradient Boosting machine learning method is used to identify predictive factors of HA outcome. SHapley Additive exPlanations Value analysis derived from the game theory is used to evaluate the individual impact of each factor.

Results: HA outcomes are significant in terms of both average improvement per patient of speech intelligibility and the percentage of patients improved. The analysis shows that the level of aided speech perception in quiet and noise is impacted by the choice of technology (category level and manufacturer), fitting parameters (amplification level and binaural loudness balancing) as well as by a high therapy adherence. In particular, binaural loudness balancing was shown to be systematically beneficial to all patients.

Conclusion: Big data analysis is a new relevant method to evaluate predictive factors for HA outcomes. It demonstrates HA efficiency to improve intelligibility in quiet and noise and shows the impact of hearing care professionals in maximizing patient's outcome through the selection of the most appropriate technology, fitting parameters, and a regular follow-up ensuring a high daily usage. However, global results must be interpreted with caution on such a heterogeneous population. They would need to be refined by an approach using clusters of patients with similar audiological profiles.

Introduction: This study aimed to investigate auditory temporal processing skills and word discrimination performance in noise among individuals with subjective tinnitus and normal hearing.

Methods: Fifty-five individuals were included: 27 individuals with chronic subjective tinnitus in the study group and 28 healthy individuals in the control group. Interventions included the Word-in-Noise Discrimination Test (WIND), auditory temporal processing tests (Gap Detection Test [GDT] and Forward Masking Test [FMT]), the Standardized Mini Mental Test for cognitive assessment, and the Tinnitus Handicap Inventory to evaluate the impact of tinnitus.

Results: In the GDT and FMT results, both right and left ear values indicated significantly poorer performance in the study group compared to the control group (CG, p < 0.05). A significant difference was also observed between the study and CGs in the WIND test results (p < 0.05). However, when the study group was divided into two subgroups based on the presence or absence of WIND problems, no significant difference in GDT and FMT performance was found between the subgroups (p > 0.05). This may be due to the limited sample size in these subgroups (n = 9 vs. n = 18), which may have reduced the statistical power to detect subtle effects.

Conclusion: Tinnitus poses a significant burden for patients; thus, assessing its impact on daily activities and quality of life is essential.

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 100%, 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 100%, and a PPV of 100% were found. For detecting basal kinking, a sensitivity of 66%, a specificity of 100%, and a PPV of 100% were determined.

Conclusion: The algorithm was found to be an effective screening tool for detecting tip fold-over or basal kinking.

Introduction: This study aimed to translate the Skarzynski Tinnitus Scale (STS) into Arabic, conduct a cross-cultural adaptation, and validate its psychometric properties.

Methods: The translation and cross-cultural adaptation of the STS were carried out in five main steps. A total of 152 participants were divided into two groups: 79 (52%) cases complaining of tinnitus and 73 (48%) in the control group without tinnitus.

Results: The scale required no substantial modifications during the translation process. Internal consistency was measured by Cronbach α for each of the three subscales and the total score. The overall psychological distress subscale, Cronbach α was 0.815; for the functional scale α was 0.787; for the coping subscale α was 0.555; and for global STS, α was 0.921. The STS global score and the psychological distress subscale had extremely high consistency.

Conclusion: The translation and adaptation of the STS established linguistic and Arabic cultural equivalence with the original version. Furthermore, the adapted version demonstrated good internal consistency. The results suggest that the STS is suitable for use in a clinical setting.

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.

Introduction: Worldwide around 400 million people suffer from hearing loss. There is increasing evidence that hearing loss is a modifiable risk factor for cognitive decline. However, several risk factors for cognition are common in hearing-impaired individuals, including vestibular dysfunction, anxiety, and depression. This study aimed to explore the effect of hearing loss on cognitive functioning in older adults, considering the effects of vestibular function, anxiety, and depression on cognitive performance.

Method: A cross-sectional study was performed on 42 subjects with moderate-to-severe sensorineural hearing loss (SNHL) and 42 matched normal-hearing controls. Matching was based on the following factors; sex, age, education level, level of anxiety and depression, and vestibular function. The test battery consisted of a cognitive assessment (Repeatable Battery for the Assessment of Neuropsychological Status adjusted for the Hearing Impaired [RBANS-H]), hearing assessment (Pure Tone Average and speech-in-noise testing), and vestibular assessment (video Head Impulse Test [vHIT]). Depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI) questionnaires.

Results: A significantly lower total cognitive (RBANS-H) score was observed in the group with SNHL compared to controls (100.93 [12.94] vs. 108.88 [10.47], p = 0.003). The difference among both groups was most pronounced in the subdomains Visuospatial/Constructional (92.90 [16.32] vs. 103.12 [12.83], p = 0.002) and Attention (96.62 [12.52] vs. 104.02 [11.81], p = 0.007). The other subdomains Immediate Memory, Language, and Delayed Memory did not differ significantly between the groups with SNHL and the normal-hearing controls.

Conclusion: The results of this study indicate that hearing loss negatively affects cognitive functioning, even in older adults with normal vestibular function.

Background: Since first introduced in the mid-1980s, cochlear implant (CI) technology has significantly evolved to reach the current state of the art. Commencing with straight, lateral wall electrode arrays, advances in the last decade led to the development of slim perimodiolar arrays that lie closer to the electrically targeted spiral ganglion. Over the years, as a consequence of improving hearing benefits, CI indications have been steadily expanded. Today, individuals with moderately severe-to-profound sensorineural hearing loss, many with residual hearing in the low-frequency range, may receive a CI in one or both ears.

Summary: Before implantation, individual recipient characteristics, such as years of auditory deprivation, hearing thresholds, and speech understanding ability with conventional amplification, can have an effect on CI hearing outcomes. Also individuals with normal hearing/mild hearing loss in the low frequencies can also qualify for CI. Surgical procedures such as careful, soft surgery techniques are imperative to reduce cochlear trauma and optimize outcomes and can be supported by surgical guidance tools and drug therapies to help preserve the delicate intracochlear structures and also for patients with single-side deafness. Histopathological investigations provide evidence that support the design concept of slim perimodiolar electrode arrays. Modiolar proximity and scalar tympani location permit energy-efficient, focused electrical stimulation of the targeted neural interface, while minimizing injury to the fine structures of the intracochlear lateral wall and its blood supply.

Key messages: Modiolar electrode arrays may provide highly consistent scala tympani placement and modiolar proximity which may improve functional hearing outcomes, compared to lateral wall electrode array results. Modiolar proximity can result in narrower spread of excitation, reduced channel interaction, lower electrical stimulation thresholds and may improve speech understanding. Reservation of functional residual low-frequency hearing is possible with both straight and perimodiolar electrode arrays.

Introduction: The clinical saccadometry test is an ocular motor test that provides a functional assessment of the brain regions and circuits involved in the generation of saccadic eye movements. Clinical saccadometry is thought to be more sensitive to concussions and neurodegenerative disorders. The aim of our study was to compare healthy individuals with individuals diagnosed with relapsing-remitting multiple sclerosis (RRMS) using a saccadometry test, and to evaluate pro-saccade and anti-saccade performances.

Methods: The study included 32 patients (mean age: 41 ± 11.88 years) between the ages of 18-60 years with relapsing remitting multiple sclerosis (RRMS), and a healthy control group of 28 individuals (mean age: 37.3 ± 12.2 years). Spontaneous nystagmus, gaze, random saccade, pursuit, and optokinetic and saccadometry tests included in the videonystagmography (VNG) test battery were performed for all participants.

Results: There were no significant differences in random saccade (RS) latencies between the groups (p > 0.05). However, the pro-saccade and anti-saccade latencies were significantly prolonged in the multiple sclerosis (MS) group (p < 0.05). There were no statistically significant differences between the groups in peak velocity and accuracy for random saccades, pro-saccades, and anti-saccades (p > 0.05). Directional error rates in the pro-saccade and anti-saccade tests were significantly different between the MS and control groups (p < 0.05).

Conclusion: The findings of our study show that there are significant differences in saccadometry test results between MS patients and healthy participants. Therefore, the clinical saccadometry test, which is newly added to the VNG test battery and offers short and noninvasive evaluation, could be included in the vestibular test battery for neurodegenerative diseases such as MS.

Background: Cochlear implantation (CI) has emerged as a promising intervention for children with auditory neuropathy spectrum disorder (ANSD). Several studies have investigated the efficacy of CIs in children with ANSD, demonstrating improvements in auditory performance and language skills following implantation. Whether the benefits and outcomes of CIs in children with ANSD are comparable to children with sensorineural hearing loss (SNHL) is still debatable. The present updated systematic review and meta-analysis evaluated the outcomes of CI for children with ANSD compared to children with SNHL.

Methods: A meta-analysis was conducted on studies that included pediatric patients and the outcomes of CI in patients with ANSD versus SNHL were compared. A comprehensive search was performed using the following electronic databases: PubMed, Scopus, Web of Science, EBSCOhost, and Cochrane Central Register of Controlled Trials (CENTRAL).

Results: Fourteen studies (number of patients = 722 patients) were included. The total number of patients in the ANSD and SNHL groups in the present systematic review was 212 and 520, respectively. The most utilized assessment tests were the Speech Intelligibility Rating (SIR) and Categories of Auditory Performance (CAP) scores. The pooled estimate showed that patients with ANSD had comparable CAP scores compared to patients with SNHL (MD: -0.52, 95% CI [-1.34, 0.29], p = 0.21). Likewise, three studies reported the SIR after CI and showed comparable findings between ANSD and SNHL patients. The pooled estimate showed that patients with ANSD had comparable SIR scores compared to patients with SNHL (MD: -0.26, 95% CI [-0.65, 0.13], p = 0.19).

Conclusion: While the results show mixed findings across various outcome measures, the overall impact of CI on speech recognition and language development appears to be positive and comparable between ANSD and SNHL.