Audiology and Neuro-Otology最新文献

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.

Introduction: Bilateral cochlear implantation can be performed simultaneously or sequentially based on hearing loss and patient age, though global consensus on sequential implantation remains unresolved.

Methods: Data of 27 individuals from this patient group were included in this study. The mean chronological age of the 27 individuals included in the study was 140.93 ± 41.51 months. The mean chronological age of the participants was 25.44 ± 9.25 months at the time of early unilateral cochlear implantation (CI 1). The implantation delay of late sequential cochlear implantation (CI 2) was 115.48 ± 41.45 months. Cortical auditory evoked potential P1 latency measurements were performed at 3, 6, 9, and 12 months. The change in performance over time was analyzed based on measurements at five different time points for CI 2.

Results: There were substantial improvements in auditory perception and performance 3 months after CI 2 activation. CAEP analyses were indicative of improvements in cortical responses and positive effects of CI 2 on central auditory system plasticity. These results suggested that late second implantation might be associated with improved auditory outcomes. These improved from CAEP test P1 latency were statistically significant (p < 0.001).

Conclusion: Late CI 2 can significantly improve auditory perception and promote adaptive plasticity in individuals with prior unilateral cochlear implants. These results suggest that even late consecutive cochlear implantations may provide clinical benefit.

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.

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.