Audiometry Research Articles

The priority of audiological procedures during the COVID-19 pandemic

The priority of audiological procedures during the COVID-19 pandemic

The audiologist's role in university hearing conservation programs: Gaps and opportunities in U.S. universities.

Introduction:All universities that meet state and/or federal requirements for employees’ noise exposure must have a hearing conservation program (HCP). Universities with HCPs and Doctor of Audiology (AuD) programs could reap a range of benefits from interprofessional collaboration between these programs, including enhanced learning opportunities for AuD students; however, it is unclear whether this collaboration occurs consistently in different university settings. Despite a relatively robust literature around occupational audiology and the audiologist’s role in hearing conservation in general, few studies examine this subject in the university setting.Aim:This study seeks to provide insights into the role of the university audiologists in university HCPs that could help inform further exploration and potential pilot studies to enhance university-based occupational HCPs, ultimately supporting more rigorous professional training in occupational audiology in AuD programs.Method:This study’s primary method was a survey questionnaire delivered to audiologists at U.S. universities. Survey questions explored university audiologists’ role, involvement with their universities’ HCPs, and benefits and barriers to collaboration with the HCPs.Results:The results indicate that although audiologists report that they have participated in hearing conservation generally at their universities, the majority of respondents were not actively involved with occupational HCPs.Conclusion:Further research is needed to understand how university HCPs are managed and how effective they are. With greater awareness of audiologists’ contributions to university HCPs, their role in this important workplace program could merit expansion.

Visual Reinforcers Designed for Children with Developmental Disabilities.

A library of visual reinforcers has been created to facilitate visual reinforcement audiometry (VRA) testing in children with developmental disabilities. The library includes 45 reinforcer sets-photos or videos grouped by a common theme-that were created based on commonly reported interests of children with developmental disabilities. Each reinforce set contains a minimum of 20 unique photo or video files that can be downloaded in two formats: one for commercially available VRA reinforcement systems and another for a custom setup. The library is freely available for download online under a Creative Commons License (Creative Commons Attribution-NonCommercial 4.0 International License). Use of these materials has the potential to improve behavioral testing outcomes for children with developmental disabilities, including children with restricted interests. Future research is needed to determine the effectiveness of implementing these materials in clinical settings.

Mediating distance: new interfaces and interaction design techniques to follow and take part in remote museum visits

PurposeThis paper presents a study of a system that allows remote and onsite visitors to share a museum visit together in real time. The remote visitors are older adults at a care home and their relatives and/or friends who are at the museum. The museum visits are interactive. Meaningful stories accompany the museum exhibits, and there’s an audio channel between onsite and remote visitors. The aim of the study is to determine whether the remote visitors, i.e. older adults are able to use such technology and to study the mediated sense of spatial presence, social closeness, engagement and enjoyment in the visit. This study discusses the relationship between these aspects and factors leading to a better remote experience for older adults.Design/methodology/approachThis study has 14 onsite and 12 remote older adult participants. Standardized questionnaires measured the mediated sense of spatial presence, the experienced social closeness and the level of participants' engagement and enjoyment in the visit of the older adult participants and traced onsite visitors in their position during the visit. The audio logs were subjected to thematic content analysis.FindingsThe results show that older adults enjoy and engage in remote visits, and that there is a positive correlation between enjoyment, engagement and social closeness. The findings argue that both the audio channel and the interactive story are important for creating an affective virtual experience: the audio channel increases the sense of closeness, whereas the interactive story makes the visit more engaging, providing structure, direction and purpose to the visit.Originality/valueThis work advances the state of art in the domain of technologies for older adults and addresses the needs of this population to stay in contact with both people and places.

The effect of simulation learning on audiology and speech-language pathology students’ self-confidence related to early hearing detection and intervention: a randomized experiment

ABSTRACT The use of simulation in audiology (AUD) and speech-language pathology (SLP) fields is less than its use in other health professions. This study aimed to examine the effect of the use of simulation training sessions versus video simulation case scenarios on AUD and SLP undergraduate students’ confidence in knowledge and professional competencies of the 1–3–6 early hearing detection and intervention (EHDI) timeline. A randomized pretest-posttest control group study design was used to assess self-ratings of confidence for specific knowledge and professional competencies. Thirty-four undergraduate students (AUD = 24; SLP = 10) participated in this study. The mean age of the participants was 20.09 years (SD = ±0.79, range: 19–21 years). All AUD and SLP participants attended a lecture and then were divided into two groups: the experimental group had simulation activities, while the control group watched video-recorded scenarios followed by a discussion session. Statistically significant differences (improvements) of students’ confidence in knowledge and professional competencies were detected in both groups. The mean difference between pre- and post-test scores for the experimental group was 0.59 (p < 0.001), and it was 0.91 (p < 0.001) for the control group. The use of simulation training sessions or video simulation case sceneries can facilitate student learning. Video simulation case scenarios are feasible for teaching the 1–3–6 EHDI timeline and offer similar situations to simulation training sessions. AUD and SLP programs are encouraged to use both teaching methods.

COVID-19 and Audiological Dysfunctions: Scrutinizing Recent Evidence

COVID-19 and Audiological Dysfunctions: Scrutinizing Recent Evidence

Purpose: To demonstrate the speech-language pathology practice in patients pre and post orthognathic surgery.

The Speech-Language Pathologist is the health professional with full graduation on Speech-Language Pathology, who acts independently both in public and private services. The professional is responsible for health promotion, prevention, assessment and diagnose, guidance, therapy (habilitation and rehabilitation) and improvement of speech-language pathology features as peripheral and central hearing function, vestibular function, oral language and writing, voice, fluency, speech articulation and myofunctional orofacial system, cervical, and swallowing. Also, the professional practices teaching, research and managerial activities (2 Speech-Language Pathology Regional Council definition – CRFa2). Currently, the Federal Speech-Language Pathology Council (CFF) recognizes 12 specialties: Audiology, Language, Orofacial Myofunctional Disorders, Collective Health, Voice, Dysphagia, Educational Speech-Language Pathology, Gerontology, Neurofunctional Speech Therapy, Occupational Health Speech-Language Pathology, Neuropsychology, and Fluency. Orofacial Myofunctional Disorders: the Speech-Language Pathologist is the professional who habilitates / rehabilitates breathing, sucking, chewing, swallowing, facial expression and speech articulation which provides better life and communication conditions (CRFa2). In 1997, at Dentistry Faculty of Sao Paulo University – USP, I started as assistant Speech-Language Pathologist in research and clinic of patients from the Traumatology Orthognathic Surgery, Temporomandibular Joint Dysfunction, and Face Trauma; since then working in rehabilitation of orthognathic patients. The Speech-Language Pathologist compose the multidisciplinary team, which is essential during pre-surgery orofacial myofunctional disorder assessment and to contribute to virtual surgery planning; and after, rehabilitating the function speeding up the recovery and results. The Speech-Language Pathologist works to organize the neuromotor programming after the bones bases relocation always aiming the function according to each patient features, to assess possible adaptations and inappropriate myofunctional compensations, awareness/ comprehension/ muscle memory and functional activation. Therapeutic resources that assist clinical practice: drainage of facial edema, cryotherapy, thermotherapy, laser therapy, electrical stimulation, surface electromyography (all resources part of the professional speech-language pathologist practice).

Drugs inducing hearing loss, tinnitus, dizziness and vertigo: an updated guide.

The awareness of audio-vestibular side effects of drugs, such as hearing loss, tinnitus, dizziness and vertigo, has widely increased in the recent years. The present guide represents an update of the previous documents published by the authors in 2005 and 2011 on drug-induced ototoxicity and vestibulotoxicity. The authors performed a comprehensive analysis of audio-vestibular side effects of commercially available drugs based on the British National Formulary, a pharmaceutical reference book that contains a wide range of useful information and advice on prescription and pharmacology. Commercially available drugs and their active principles have been classified based on their audio-vestibular side effects, as reported by the pharmaceutical companies and/or health agencies. Drugs have been categorized based on the field of application, the therapeutic indication and the pharmacological properties. General practitioners, otolaryngology, neurology and audiology specialists should be aware of possible audio-vestibular side effects of drugs, such as hearing loss, tinnitus, dizziness and vertigo. The present guide represents a practical tool to rapidly identify potential audio-vestibular side effects of drugs as reported by the pharmaceutical companies and/or health agencies.

Lessons from Neil: Navigating Audiology's Challenging Landscape

Lessons from Neil: Navigating Audiology's Challenging Landscape

Optimizing Audiology Websites to Increase Patient Reach

Optimizing Audiology Websites to Increase Patient Reach

Esforço auditivo e registro do controle parassimpático do coração durante o reconhecimento de sentenças: estudo piloto

Introdução: Medidas psicofisiológicas do sistema nervoso autônomo em resposta a tarefas auditivas podem fornecer um meio de quantificar os efeitos do esforço auditivo. Objetivo: Comparar a modulação parassimpática da frequência cardíaca em situações de escuta distintas e determinar se a variabilidade da frequência cardíaca (VFC) é um índice psicofisiológico sensível para mensurar o esforço auditivo. Método: Estudo piloto, observacional, transversal e prospectivo. Participaram 14 adultos normo-ouvintes, de ambos os sexos e com idade entre 18 e 30 anos. Estes responderam a anamnese e realizaram audiometria tonal limiar para verificação de limiares auditivos. Para o registro da VFC, colocou-se a cinta do cardiofrequencímetro na região do processo xifoide e este registro foi coletado por 10 minutos para três situações distintas: “repouso”, “recuperação pós-reconhecimento de sentenças no silêncio” e “recuperação pós-reconhecimento de sentenças no ruído”. O reconhecimento de sentenças foi realizado utilizando-se duas listas de sentenças, de forma randomizada, binaural, nas situações de escuta silêncio e na relação sinal/ruído de -5 dB e, também foi registrada VFC por um período de dois minutos. Aplicou-se o teste de ANOVA de medidas repetidas seguido pelo pós-teste de Bonferroni para comparar o índice de RMSSD nos diferentes momentos de registro da VFC. Resultados: A análise estatística demonstrou que não houve diferença significante do registro da VFC nos diferentes momentos, inclusive durante a tarefa de reconhecimento de sentenças no ruído, considerada a tarefa mais árdua. Conclusão: Para esta amostra, o registro da VFC não foi considerado um índice sensível para a mensuração do esforço auditivo.

Implicações audiológicas do diabetes mellitus e da hipertensão arterial: uma revisão sistemática

Introdução: Dentre as doenças crônicas não transmissíveis (DCNT) mais prevalentes, destacam-se o Diabetes Mellitus (DM) e a Hipertensão Arterial Sistêmica (HAS). Estas DCNT se relacionam ao estilo de vida, idade e gênero, e podem estar associadas a alterações audiológicas. Objetivo: Evidenciar os estudos já existentes na literatura a respeito da DM e a HAS e a sua relação com a perda auditiva. Estratégia de pesquisa: As buscas por artigos científicos ocorreram nas bases de dados eletrônicos Medline (Pubmed), LILACS e SciELO. Critério de seleção: Foram incluídos estudos sobre a relação da perda auditiva com a DM e HAS publicados nos últimos cinco anos, e, excluídas revisões de literatura, revisões sistemáticas e meta-análises. Resultados: Foram selecionados nove estudos evidenciando que a DM e/ou a HAS podem ser possíveis fatores de risco para o desenvolvimento da perda auditiva; para isso foram realizadas avaliações e comparações de grupos de pessoas com e sem tais fatores de risco. Outras comorbidades podem ser determinantes para a perda auditiva. Após a análise, verificou-se que existe uma relação entre a HAS, DM e a perda auditiva, principalmente em altas frequências. Não foi observada nenhuma diferença entre as orelhas. Conclusão: Existe relação entre DM e HAS com a perda auditiva, tanto em adultos quanto em idosos. O comprometimento auditivo mostrou-se maior nos sujeitos que apresentavam DM e HAS associados, sugerindo um efeito sinérgico das duas doenças crônicas sobre a audição. A alteração auditiva do tipo neurossensorial prevaleceu.

Audiological Needs, Solutions in COVID-19

Audiological Needs, Solutions in COVID-19

Adherence to screening and referral guidelines for autism spectrum disorder in toddlers in pediatric primary care.

ObjectivesAlthough the American Academy of Pediatrics recommends screening for autism spectrum disorder (ASD) for all young children, disparities in ASD diagnosis and intervention in minority children persist. One potential contributor to disparities could be whether physicians take different actions after an initial positive screen based on patient demographics. This study estimated factors associated with physicians completing the follow-up interview for the Modified Checklist for Autism in Toddlers with Follow-up (M-CHAT-F), and referring children to diagnostic services, audiology, and Early Intervention (EI) immediately after a positive screen.MethodsChildren seen in a large primary care network that has implemented universal ASD screening were included if they screened positive on the M-CHAT parent questionnaire during a 16–30 month well child visit (N = 2882). Demographics, screening results, and referrals were extracted from the electronic health record.ResultsChildren from lower-income families or on public insurance were more likely to have been administered the follow-up interview. Among children who screened positive, 26% were already in EI, 31% were newly referred to EI, 11% were referred each to audiology and for comprehensive ASD evaluation. 40.2% received at least one recommended referral; 3.7% received all recommended referrals. In adjusted multivariable models, male sex, white versus black race, living in an English-speaking household, and having public insurance were associated with new EI referral. Male sex, black versus white race, and lower household income were associated with referral to audiology. Being from an English-speaking family, white versus Asian race, and lower household income were associated with referral for ASD evaluation. A concurrent positive screen for general developmental concerns was associated with each referral.ConclusionsWe found low rates of follow-up interview completion and referral after positive ASD screen, with variations in referral by sex, language, socio-economic status, and race. Understanding pediatrician decision-making about ASD screening is critical to improving care and reducing disparities.

Bilateral congenital semicircular canal malformation and hearing loss - case report

The main aims of this observational study were to describe a poorly characterized malformation of the inner ear termed bilateral congenital semicircular canal malformation; determine if the degree and pattern of semicircular canal dysmorphology and the presence or absence of a well-formed cochlea predict audiological outcomes, type, and severity of congenital hearing loss; and investigate its relationship with known syndromic forms of hearing loss. Review of eight cases of hearing loss with radiographic evidence of congenital semicircular canal malformation was performed. Information was collected on clinical history, physical examination, computed tomography study and serial audiograms for all patients. Analyzed features included other syndrome-characteristic phenotypic dysmorphologies, audiometric configuration, severity and type of hearing loss, type of audiological rehabilitation, and presence of associated inner ear abnormalities besides those in the vestibular system. Among the eight cases included in the study, six patients had recognized syndromes/chromosomal abnormalities. Hearing loss was moderate to profound in all cases. All patients had bilateral semicircular canal deformities, with usually identical anatomical pattern on each side. Of the eight cases, six had normal cochlear development; malformations in the tympanic membrane and external auditory canal were only found in one; changes in ossicular chain were found in three patients; vestibules and vestibular aqueduct were normal in most cases; and abnormalities of oval window development and hypoplasia were found in two cases. The present study shows that a correlation between the severity and type of hearing loss and radiographic abnormalities is difficult to establish. Hearing loss associated with semicircular canal dysplasia is more likely due to anomalous membranous labyrinth development, which is not radiologically detectable by computerized tomography scan.

Field test of the Rapid Assessment of Hearing Loss survey protocol in Ntcheu district, Malawi

Objective: (1) To test the feasibility of the Rapid Assessment of Hearing Loss (RAHL) survey protocol in Malawi (Ntcheu); (2) To estimate the prevalence and probable causes of hearing loss (adults 50+).Design: Cross-sectional population-based survey.Study sample: Clusters (n = 38) were selected using probability-proportionate-to-size-sampling. Within each cluster, 30 people aged 50+ were selected using compact-segment-sampling. All participants completed smartphone-based audiometry (hearTest). Prevalence was estimated using WHO definitions (PTA of thresholds 0.5, 1, 2, 4 kHz in the better ear of >25 dB HL (any) and >40 dB HL (≥moderate)). Otoscopy and questionnaire were used to assess probable causes. Participants with hearing loss and/or ear disease were asked about care-seeking and barriers.Results: Four teams completed the survey in 24 days. 1080 of 1153 (93.7%) participants were examined. The median time to complete the protocol was 24 min/participant. Prevalence of hearing loss was 35.9% (95% CI = 31.6–40.2) (any level); and 10.0% (95% CI = 7.9–12.5) (≥moderate). The majority was classified as probable sensorineural. Nearly one third of people (30.9%) needed diagnostic audiology services and possible hearing aid fitting. Hearing aid coverage was <1%. Lack of perceived need was a key barrier.Conclusion: The RAHL is simple, fast and provides information about the magnitude and probable causes of hearing loss to plan services.

Field-testing of a rapid survey method to assess the prevalence and causes of hearing loss in Gao\u2019an, Jiangxi province, China

BackgroundThe Rapid Assessment of Hearing Loss (RAHL) survey protocol aims to measure the prevalence and causes of hearing loss in a low cost and rapid manner, to inform planning of ear and hearing services. This paper reports on the first field-test of the RAHL in Gao’an County, Jiangxi Province, China. This study aimed to 1) To report on the feasibility of RAHL; 2) report on the estimated prevalence and causes of hearing loss in Gao’an.MethodsA cross-sectional population-based survey was conducted in September–October 2018. Forty-seven clusters in Gao’an County were selected using probability-proportionate-to-size sampling. Within clusters, compact segment sampling was conducted to select 30 people aged 50+. A questionnaire was completed covering sociodemographics, hearing health, and risk factors. Automated pure-tone audiometry was completed for all participants, using smartphone-based audiometry (hearTest), at 0.5, 1, 2, 4 kHz (kHz). All participants had their ears examined by an Ear Nose and Throat (ENT) doctor, using otoscopy, and probable causes of hearing loss assigned. Prevalence estimates were age and sex standardised to the Jiangxi population. Feasibility of a cluster size of 30 was examined by assessing the response rate, and the proportion of clusters completed in 1 day.Results1344 of 1421 eligible participants completed the survey (94.6%). 100% of clusters were completed in 1 day. The survey was completed in 4.5 weeks. The prevalence of moderate or greater hearing loss (pure-tone average of 0.5, 1, 2, 4 kHz of > = 41dBHL in the better ear) was 16.3% (95% CI = 14.3, 18.5) and for any level of hearing loss (pure-tone average of > = 26dBHL in the better ear) the prevalence was 53.2% (95% CI = 49.2, 57.1). The majority of hearing loss was due to acquired sensorineural causes (91.7% left; 92.1% right). Overall 54.0% of the population aged 50+ (108,000 people) are in need of diagnostic audiology services, 3.4% were in need of wax removal (7000 people), and 4.8% were in need of surgical services (9500 people). Hearing aid coverage was 0.4%.ConclusionThe RAHL survey protocol is feasible, demonstrated through the number of people examined per day, and the high response rate. The survey was completed in a much shorter period than previous all-age surveys in China. Some remaining challenges included assignment of causes of probable sensorineural loss. The data obtained from this survey can be used to scale-up hearing services in Gao’an.

Audiology Transfer of Care

Audiology Transfer of Care

Study on use of platelet-rich plasma in myringoplasty

Aim: This study aims to analyze the use of autologous platelet-rich plasma (PRP) to improve graft uptake and benefit on hearing after myringoplasty. Objectives: The objective is to compare pre- and post-operative graft uptake and audiological benefit following myringoplasty with and without PRP. Materials and Methods: A total of 70 patients diagnosed with chronic suppurative otitis media tubotympanic type were divided into groups of 35 each. Patients in group one who underwent myringoplasty with PRP while in second group underwent myringoplasty without PRP. Pre- and post-operative graft status and pure tone audiometry were performed for all the patients, and the outcomes were compared. Results: Of 35 patients in each group; four in the study group and eight in the control group had residual perforation. Graft uptake in case group was 88.57% and graft uptake in the control group was 77.1%. Result was better in cases that underwent myringoplasty with PRP. Of 35 patients in case group, audiological improvement (>10 dB) was seen in 31 patients (88.57%), whereas in the control group of 35 patients, 27 (77.1%) had audiological benefits. Conclusion: This study shows there is a definite benefit using PRP in myringoplasty. As the PRP can be easily prepared, PRP myringoplasty can be routinely performed.

Study of brainstem evoked response audiometry in medical students having long time mobile usage

Background: Mobile phones are undoubtedly one of the most revolutionizing inventions of the 21st century and are indispensable communication tools. Concomitantly, there has also been a potential increase in the health risks associated with prolonged mobile phone usage. Electromagnetic radiations emitted from telecommunication systems absorbed by the recipient's body may bring about changes in the brain electrical activity. Brainstem evoked response audiometry allows quantifying the activity of auditory pathway, and hence, the present study was undertaken to evaluate the auditory evoked potentials in the MBBS students who have been long-term mobile users. Materials and Methods: The study was conducted using Evoked Potential Recorder (RMS EMGEP MARK-II) in the Neurophysiology unit, Department of Physiology, Mahatma Gandhi Institute of Medical Sciences. This was an observational noninterventional study design incorporating a total of 50 MBBS students, from institutional campus using mobile phones for >1 year. 25 students who used mobile phones for 30 min/day formed the test group. Results: The mean age among the test group was 17.5 ± 1.4 years and among controls was 16.2 ± 2.0 years. The average latency (both the right and left ear) of waves I–V and interpeak latencies (IPLs) I–III, III–V, and I–V waves were found to be prolonged (P > 0.001) in the test group when compared to controls. The mean latencies of the left ear were significantly (P