Hearing Loss Research Articles

Imaging of Osteomyelitis

In this paper, an analysis of the demographic attributes, presenting symptoms, and infective agents, as well as the areas affected by skull osteomyelitis, of fifty male and fifty female patients is offered. A rough age estimate of around 61 years was found among the patients, with average symptom durations of about 6.8 months or longer. A significant percentage of diabetes (62%) and cranial nerve involvement (62%) were observed. The dominant symptom was headaches, representing 78% of cases, followed by cranial nerve palsy (62%) and hearing loss (48%). S. aureus was found to be the second most common causative agent, following only P. aeruginosa, which was the most common agent (54%). It became clear that there was a relevant infection in the temporomandibular joint and the retropharyngeal joint upon examining regional cases of the illness. In spite of therapy, only 38 percent of patients exhibited a cure, while 46 percent demonstrated improvement and 16 percent experienced a worsening of their condition.

Neonatal Hearing Screening Using Wideband Absorbance and Otoacoustic Emissions Measured Under Ambient and Pressurized Conditions

Background: The objective was to analyze wideband acoustic absorbance and transiently evoked otoacoustic emissions (TEOAEs) from newborns without risk indicators of hearing loss and test the effectiveness of measuring TEOAEs under pressurized ear canal conditions. Methods: Evaluation of 102 newborns from a maternity hospital, who stayed in the well-baby nursery and did not have risk indicators for hearing loss. The procedures involved wideband tympanometry and TEOAEs performed at ambient pressure (AP) and at a pressure corresponding to maximum compliance (PP). Newborns were then divided into three groups according to their AP and PP results: G1 (PASS/PASS), G2 (FAIL/PASS), and G3 (FAIL/FAIL). Results: Comparing the three groups, pressurization improved the pass rate for G2 only. For wideband absorbance, differences were statistically significant for frequencies of 2, 3, and 6 kHz, with lower values under the AP condition. For TEOAEs, the differences were statistically significant in all bands, with lower values under the AP condition. Conclusions: Pressurization was effective in detecting more TEOAEs in G2, thus reducing the number of failures in neonatal hearing screening and reducing the need to return for retesting.

Risk factors for treatment-related sensorineural hearing loss and hearing aid use in medulloblastoma patients: an observational cohort study.

This study aimed to analyze treatment-related risk factors for sensorineural hearing loss (SNHL) and an indication for hearing aids (IHA) in medulloblastoma patients after craniospinal radiotherapy (CSRT) and platin-based chemotherapy (PCth). Atotal of 58patients (116 ears) with medulloblastoma and clinically non-relevant pre-treatment hearing thresholds were included. Cranial radiotherapy and PCth were applied sequentially according to the HIT 2000 study protocol or post-study recommendations, the NOA-07 protocol, or the PNET (primitive neuroectodermal tumor) 5MB therapy protocol. Audiological outcomes up to amaximum post-therapeutic follow-up of 4years were assessed. The incidence, post-treatment progression, and time-to-onset of SNHL, defined as Muenster classification grade ≥MS2b, were evaluated. Risk factors for IHA were analyzed separately. While 39patients received conventionally fractionated RT (CFRT; group1), 19patients received hyperfractionated RT (HFRT; group2). Over amedian follow-up of 40months, 69.2% of ears in group1 experienced SNHL ≥MS2b compared to 89.5% in group2 (p = 0.017). In multivariable Cox regressions analysis, younger age and increased mean cochlear radiation dose calculated as the equivalent dose in 2‑Gy fractions (EQD2) were associated with time-to-onset of SNHL ≥MS2b (p = 0.019 and p = 0.023, respectively) and IHA (p < 0.001 and p = 0.016, respectively). Tomotherapy and supine positioning were associated with alower risk for IHA in univariable modelling only (p = 0.048 and p = 0.027, respectively). Young age and cochlear EQD2 Dmean ≥40 Gy are significant risk factors for the incidence, degree, and time-to-event of SNHL as well as for IHA in medulloblastoma patients.

New Quadratic Discriminant Analysis Algorithms for Correlated Audiometric Data.

Paired organs like eyes, ears, and lungs in humans exhibit similarities, and data from these organs often display remarkable correlations. Accounting for these correlations could enhance classification models used in predicting disease phenotypes. To our knowledge, there is limited, if any, literature addressing this topic, and existing methods do not exploit such correlations. For example, the conventional approach treats each ear as an independent observation when predicting audiometric phenotypes and is agnostic about the correlation of data from the two ears of the same person. This approach may lead to information loss and reduce the model performance. In response to this gap, particularly in the context of audiometric phenotype prediction, this paper proposes new quadratic discriminant analysis (QDA) algorithms that appropriately deal with the dependence between ears. We propose two-stage analysis strategies: (1) conducting data transformations to reduce data dimensionality before applying QDA; and (2) developing new QDA algorithms to partially utilize the dependence between phenotypes of two ears. We conducted simulation studies to compare different transformation methods and to assess the performance of different QDA algorithms. The empirical results suggested that the transformation may only be beneficial when the sample size is relatively small. Moreover, our proposed new QDA algorithms performed better than the conventional approach in both person-level and ear-level accuracy. As an illustration, we applied them to audiometric data from the Medical University of South Carolina Longitudinal Cohort Study of Age-related Hearing Loss. In addition, we developed an R package, PairQDA, to implement the proposed algorithms.

Compound Heterozygous Loss of Allele Coding for KCNJ16 in an Adult Presenting as Recurrent Hypokalemic Periodic Paralysis with Metabolic Acidosis and Hypokalemia

A 20-year-old male presented with fever and rapidly progressive muscle weakness. He had hypokalemia and metabolic acidosis, suggesting renal tubular acidosis (RTA). Further investigation revealed distal RTA with preserved acidification. A channelopathy was suspected. Whole exome sequencing identified a novel biallelic mutation in the KCNJ16 gene, which encodes the Kir5.1 protein. This is the first reported case of an Indian adult with biallelic KCNJ16 mutations presenting as pure renal phenotype without sensory neural hearing loss or cardiac manifestation.

Impact of age-related hearing loss on decompensation of left DLPFC during speech perception in noise: a combined EEG-fNIRS study.

Understanding speech-in-noise is a significant challenge for individuals with age-related hearing loss (ARHL). Evidence suggests that increased activity in the frontal cortex compensates for impaired speech perception in healthy aging older adults. However, whether older adults with ARHL still show preserved compensatory function and the specific neural regulatory mechanisms underlying such compensation remains largely unclear. Here, by utilizing a synchronized EEG-fNIRS test, we investigated the neural oscillatory characteristics of the theta band and synchronous hemodynamic changes in the frontal cortex during a speech recognition task in noise. The study included healthy older adults (n = 26, aged 65.4 ± 2.8), those with mild hearing loss (n = 26, aged 66.3 ± 3.8), and those with moderate to severe hearing loss (n = 26, aged 67.5 ± 3.7). Results showed that, relative to healthy older adults, older adults with ARHL exhibited lower activation and weakened theta band neural oscillations in the left dorsolateral prefrontal cortex (DLPFC) under noisy conditions, and this decreased activity correlated with high-frequency hearing loss. Meanwhile, we found that the connectivity of the frontoparietal network was significantly reduced, which might depress the top-down articulatory prediction function affecting speech recognition performance in ARHL older adults. The results suggested that healthy aging older adults might exhibit compensatory attentional resource recruitment through a top-down auditory-motor integration mechanism. In comparison, older adults with ARHL reflected decompensation of the left DLPFC involving the frontoparietal integration network during speech recognition tasks in noise.

Association of Spouses’ Sensory Loss with Depressive Symptoms, Self-Reported Health, and Functional Disability Among Middle-Aged and Older Adults in China: A Cross-Sectional Study

ABSTRACT Objective To investigate cross-sectional associations between spouses’ sensory loss and depressive symptoms, self-rated health, and functional disability. Methods We included 10,410 individuals from the China Health and Retirement Longitudinal Study. We used the cross-sectional design and determined hearing loss, vision loss, and dual sensory loss by self-reports. We assessed depressive symptoms using the Center for Epidemiological Studies Depression Scale. We assessed self-reported health status using one item. Functional disability was defined as having difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). Results Individuals with spouses’ dual sensory loss had a higher prevalence of depressive symptoms (45.19%), ADL (17.31%), and IADL impairments (21.97%) and a lower rate of self-rated good health (20.78%) than those with no or single loss. Spouse’s sensory loss was associated with depressive symptoms, self-rated health, ADL, and IADL impairments (p < .05). Husbands’ ADL impairments were associated with wives’ vision loss (p < .05). Wives’ IADL impairments were associated with husbands’ hearing loss (p < .05). Conclusions Spouses’ sensory loss was related to depressive symptoms, self-rated health, ADL, and IADL impairments. There was a gender specificity in the effect of spousal vision loss or hearing loss on ADL and IADL impairments.

Evaluation of auditory system in vitiligo patients: A case-control study

BackgroundVitiligo is a common acquired pigmentary disorder characterized by well-defined areas of depigmentation due to loss of melanocytes. Vitiligo can affect melanocytes in the auditory system and potentially hearing. ObjectiveThe aim of this study was to investigate hearing changes in vitiligo patients. MethodsTwenty-six with vitiligo patients and 26 demographically matched healthy controls were included in this study. Audiological function was evaluated using pure tone audiometry (PTA), speech audiometry and tympanometry tests in all subjects. ResultsThe mean hearing threshold of the left ear at frequencies of 250 and 8000 Hz in vitiligo patients was significantly higher than the control group. Sensorineural hearing loss (SNHL) was seen in 14 (53.8 %) vitiligo patients and 5(19.2 %) control group (p < 0.05). Most affected patients (10/14; 71 %) had bilateral hearing loss especially in high frequency (8000 Hz). A significant association was identified between vitiligo and SNHL (OR 4.9; 95 % CI, 1.41–16.98, P = 0.01). There was a statistically significant correlation between hearing impairment and age in both groups. Gender, severity, activity and duration of vitiligo had no a significant effect on the results of audiometric tests. ConclusionThis study confirmed that the auditory system was affected in vitiligo patients. Vitiligo patients might be at a higher risk for auditory abnormalities at a younger age than control subjects. Auditory evaluation of vitiligo patients should be considered for early detection of hearing loss.

Audiological and Subjective Benefits in a Child with Microtia and Atresia After Sequential Bilateral Implantation with Active Bone Conduction Devices: A Case Study

Background: With bilateral hearing loss, the main problems for the patient are speech understanding in noise and, especially in asymmetrical hearing loss, an inability to correctly localize sound sources. There are multiple methods of treatment and rehabilitation for people with conductive hearing loss, and one of them is to use an active bone conduction implant. This case study is designed to evaluate the auditory benefits and sound localization accuracy with active bilateral bone conduction implants—in comparison to unilateral ones—in a patient with congenital bilateral conductive hearing loss caused by a congenital malformation. We assess subjective and audiological benefits (functional, directional hearing, speech comprehension in quiet and noise). Case report: This study describes the results in a 15-year-old patient with bilateral congenital malformation of the outer ears and associated conductive hearing loss who was treated with two Bonebridge active bone conduction implants. Speech recognition ability, hearing thresholds, and sound localization were tested under three conditions: unaided, unilateral on the right-side, and bilateral on both sides. The patient filled in an Abbreviated Profile of Hearing Aid Benefit questionnaire (APHAB) to evaluate limitations in daily life caused by hearing impairment. The results show an improvement in free-field hearing thresholds and the ability to discriminate speech, both in quiet and in noise after implantation. Subjectively, the patient had significantly fewer problems with two implants than with one (or with no implant) in terms of hearing in everyday situations. Conclusions: Unilateral use of the Bonebridge device in a patient with congenital bilateral conductive hearing loss did not provide full benefits. However, bilateral implantation improved speech understanding in noise and sound localization.

Noise Exposure and Hearing Loss Among Landscape and Groundskeepers.

Excessive noise exposure within the working population is a health concern that has received increased attention in recent years. Levels have been established by national organizations that reflect safe exposure, but many kinds of equipment used in the landscaping and groundskeeper industries still exceed them. While noise risks are often long-term in nature and occur with cumulative exposure, prevention and exposure methods can still be used by employers to protect their workers' long-term health. Recalling the hierarchy of controls established by the National Institute for Occupational Health and Safety (NIOSH), various strategies can be implemented without creating excessive supervisory burden and with minimal costs. Occupational health nurses can further help reduce excessive noise exposure by encouraging the use of an easy-to-use noise-level assessment app created by NIOSH.

A retrospective study on biotinidase deficiency: analysis of the Eastern Anatolia region patient cohort

ABTRACT This study retrospectively reviews individuals diagnosed with biotinidase deficiency in Eastern Anatolia to analyze the genetic variants and their relationship with biotinidase activity levels. The research focuses on determining the percentage impact of different variants on enzyme activity. The study included 357 patients who presented to Erzurum City Hospital with symptoms of biotinidase deficiency between 2018 and 2023 and were referred to the medical genetics department. Biotinidase enzyme levels were determined using spectrophotometric and colorimetric techniques, while Sanger sequencing analyzed the four exons and intron boundaries of the BTD gene. In the analysis of 357 patients (181 boys, 176 girls), the most frequent variant was c.1270G > C | p.Asp424His. Biotinidase enzyme activity was above 30% in 97.3% of patients with a homozygous p.D424His mutation. The mutations that caused the most significant decrease in enzyme activity were c.410G > A p.Arg137His, c.38_delinsTCC p.Cys13phefs*36, and c.1535C > T p.Thr512Met. Hearing loss (4 patients) and optic atrophy (1 patient) were mainly observed in patients with the c.38_delinsTCC mutation (homozygous or heterozygous). Most patients were asymptomatic, and mild symptoms were effectively prevented with biotin treatment. This study provides a detailed analysis of genetic diversity and clinical presentation in biotinidase deficiency cases in Eastern Anatolia, demonstrating the efficacy of biotin treatment. It highlights the significant role of genetic variants in phenotypic diversity and the need for personalized treatment, calling for further genetic research to enhance understanding of variant diversity and its impact on enzyme activity.

Effectiveness of CI as an alternative to ABI for hearing loss in patients with vestibular schwannomas: A multicenter study in Japan

ObjectiveNF2-related schwannomatosis (NF2) is characterized by bilateral vestibular schwannomas (VS), often causing severe damage to the bilateral auditory function. Auditory brainstem implantation (ABI) provides hearing-impaired patients with an opportunity to reacquire auditory sensation through electrical stimulation of auditory neurons in the cochlear nucleus. However, ABI is not covered by public health insurance in Japan, leading to a large difference in financial burden compared to cochlear implantation (CI). The aim of the present study was to demonstrate the effectiveness of CI as an alternative to ABI for hearing reacquisition in patients with profound hearing loss caused by VS. MethodsTo investigate the current situation of ABI and CI for hearing reconstruction in VS patients, we conducted a questionnaire survey of 102 facilities in Japan. Based on the responses to the questionnaire, a multicenter research group consisting of otolaryngologists and neurosurgeons was established. We collected detailed data on patients with VS who underwent ABI (n = 7, all NF2) and CI (n = 14 [nine NF2, and five non-NF2]). ResultsSome sense of hearing was obtained in all patients but one with CI indicating the efficacy of CI and ABI for profound hearing loss caused by VS. The mean hearing levels were 45.4 dB HL in the ABI patients and 32.7 dB HL in the CI patients, indicating that CI was effective as an alternative to ABI. ConclusionThe results of the present study suggest the effectiveness of CI as an alternative to ABI for hearing reacquisition in patients with profound hearing loss caused by VS. Level of evidence4.

A primate model animal revealed the inter-species differences and similarities in the subtype specifications of the spiral ganglion neurons

Type I spiral ganglion neurons are peripheral neurons essential for hearing perception. While they can be subdivided in mice based on characteristic gene expression patterns, detailed examinations of these subtypes in primates and humans are lacking. In this study, we investigated the developmental subtypes of spiral ganglion neurons in the common marmoset (Callithrix jacchus). We confirmed that Type I spiral ganglion can be divided based on the characteristic gene expression patterns of several marker genes. However, some combinations of these genes differ from those in rodents, suggesting common marmoset's suitability for advancing our understanding of human cochlear development. Additionally, identifying the essential time points for subtype specifications and subsequent maturation will aid in studying the primate-specific developmental biology of the inner ear. This could lead to new treatment strategies for hearing loss in humans and be valuable for studying age-related hearing loss, as well as designing regenerative therapies.

Diffusion Tensor Imaging of the Auditory Pathway in Prelingual Deaf Children in Comparison to Normal Hearing Children in the 1 to 7 Years of Age Group

Abstract Objective This article aims to determine the microstructural alterations in the auditory pathway in prelingual deaf children using diffusion tensor imaging (DTI)-derived parameters—fractional anisotropy (FA) and apparent diffusion coefficient (ADC), and secondarily to evaluate these changes in rubella and cytomegalovirus (CMV) positive cases. Method A consecutive series of consenting deaf and normal children between 1 and 7 years of age, forming the case and control groups, respectively, underwent DTI, audiological tests, and testing for rubella, CMV, and toxoplasma infections. FA and ADC were measured at four locations bilaterally: lateral lemniscus (LL), inferior colliculus, medial geniculate body, and auditory cortex (AC). Result The mean ADC values were higher and the mean FA values were lower in cases (19 males, 21 females, mean age 2.65 years) than the controls (21 males, 19 females, mean age 4.63 years) at all eight sites. Sixteen (40%), 17 (42.5%), and 7 (17.5%) cases had severe, severe to profound, and profound hearing loss, respectively, the FA and ADC values being significantly different for LL. For rubella and CMV immunoglobulin G, 20/40and 17/40 cases were positive, respectively, 11 for both, and none for toxoplasma. Significant decrease in FA was seen at LL and AC in rubella/CMV positive cases. Conclusion Microstructural changes are seen throughout the auditory pathway in prelingual deaf children, especially with rubella and/or CMV positive status. Further studies may pave the path to segregate out patient groups potentially more responsive to cochlear implant.

Beyond the cochlea: exploring the multifaceted nature of hearing loss in primary mitochondrial diseases

Abstract Primary mitochondrial diseases, with diverse systemic manifestations, often present with auditory impairments due to mitochondrial dysfunction. This study provides an in-depth exploration of auditory deficits in primary mitochondrial diseases, highlighting the impact of various pathogenic variants on both cochlea and neural/central auditory functions. An observational study involving 72 adults with primary mitochondrial diseases was conducted. Participants underwent extensive audiological evaluations including Pure-Tone Audiometry, Tympanometry, Acoustic Reflex Thresholds, Quick Speech-in-Noise Test, Listening in Spatialized Noise-Sentences test, Auditory-evoked Brainstem Responses, and Distortion Product Otoacoustic Emissions. Multivariate Analysis of Covariance and logistic regression analyses assessed the influence of various pathogenic DNA variants, accounting for age, cognitive status via the Montreal Cognitive Assessment, and disease severity through the Newcastle Mitochondrial Disease Adult Scale. Participants with the pathogenic m.3243A&amp;gt;G/T variants (m.3243A&amp;gt;G n=40; m.3243A&amp;gt;T n=1) exhibited significant elevations in Pure-Tone Audiometry thresholds, especially at high frequencies, suggesting cochlea involvement. Notably, the Listening in Spatialized Noise-Sentences test showed significant spatial processing deficits in the m.3243A&amp;gt;G/T group, possibly indicating a unique mutation-specific impact on central auditory processing. Auditory-evoked Brainstem Responses results highlighted a higher likelihood of auditory brainstem response abnormalities in this group, further substantiating neural/central auditory pathway involvement. This study emphasises the heterogeneous nature of hearing impairment in primary mitochondrial diseases, with a genotype-phenotype correlation, particularly in the m.3243A&amp;gt;G/T group. These insights advocate for personalised, genotype-specific auditory assessments and targeted management strategies. Conventional hearing aids and cochlear implants are ineffective for those with central auditory dysfunctions related to mitochondrial mutations. There is an urgent need for innovative rehabilitation strategies catering for both cochlear and neural/central auditory pathways.

Hearing Loss and Alzheimer Disease.

Several studies have been done to investigate the role of hearing loss (HL) in cognitive decline. A co-existence of these two conditions has been identified. Recently, thanks to the use of functional MRI and EEG it has been shown that untreated HL can expose patients with cognitive decline to a higher risk of developing Alzheimer Disease (AD). This chapter will discuss the difference between central and peripheral HL, the link between HL and cognition and the relationship between HL and AD. At the end of the chapter the available technologies to treat HL will be discussed as well as their impact on memory and cognition.

The Otoacoustic Emissions in the Universal Neonatal Hearing Screening: An Update on the European Data (2004 to 2024)

Background: The reported data on European universal neonatal hearing screening (UNHS) practices tend to be scarce, despite the fact that the European Union project, EUScreen, collected unofficial data from 38 collaborating European institutions. The objectives of this systematic review were as follows: (a) to identify the most recent (in a 20-year span) literature information about UNHS programs in Europe and (b) to provide data on the procedures used to assess the population, the intervention policies, and on the estimated prevalence of congenital hearing loss with emphasis on the bilateral hearing loss cases. Methods: Queries were conducted via the Pubmed, Scopus and Google Scholar databases for the time period of 2004–2024. The Mesh terms used were “OAE”, “Universal Neonatal Hearing Screening”, “congenital hearing loss” and “well babies”. Only research articles and review papers of European origin were considered good candidates. The standard English language filter was not used, in order to identify information from non-English-speaking scientific communities and groups. Results: Very few data and reports were identified in the literature search. Eleven manuscripts were identified corresponding to eight UNHS programs. Except in Poland, most of the data refer to regional and not national programs. The screening coverage estimates of all programs exceed 90%; infants were mostly assessed by a three-stage protocol (TEOAE + TEOAE + AABR), followed by a clinical ABR test. The average prevalence (i.e., from well babies AND NICU infants) of bilateral hearing loss ranged from 0.5 to 20.94 per 1000 (Zurich sample). Infants presenting unilateral or bilateral hearing losses were first rehabilitated by hearing aids and consequently (&gt;15 mo) by cochlear implants. Conclusions: Even though UNHS programs are well-established clinical practices in the European States, the amount of information in the literature about these programs is surprising low. The existing data in the timespan 2004–2024 corroborate the international UNHS data in terms of coverage and bilateral hearing loss prevalence, but there is a strong need to supplement the existing information with the latest developments, especially in the area of hearing loss rehabilitation.

Targeted gene sequencing and hearing follow-up in 7501 newborns reveals an improved strategy for newborn hearing screening.

Hearing loss is a common congenital condition. Concurrent newborn hearing and limited genetic screening has been implemented in China for the last decade. However, the role of gene sequencing screening has not been evaluated. In this study, we enrolled 7501 newborns (52.7% male, 47.3% female) in our Newborn Screening with Targeted Sequencing (NESTS) program, and 90 common deafness genes were sequenced for them. Hearing status assessments were conducted via telephone from February 2021 to August 2022, for children aged 3 to 48 months. Of the universal newborn hearing screening, 126 (1.7%) newborns did not pass. Targeted sequencing identified 150 genetically positive newborns (2.0%), with 25 exhibiting dual-positive results in both screening. Following diagnostic audiometry revealed 18 hearing loss newborns and half of them had abnormal results in both screening. The positive predictive value for universal newborn hearing screening alone was merely 14.3% (18/126). However, when combined with targeted sequencing, this rate increased to 36.0% (9/25). Furthermore, limited genetic screening identified 316 carriers of hot-spot variants, but none exhibited biallelic variants. All 15 hot-spot carriers who failed physical screening demonstrated normal hearing during follow-up. In this cohort study of 7501 Newborns, Combining targeted sequencing with universal newborn hearing screening demonstrated technical feasibility and clinical utility of identifying individuals with hearing loss, especially when coupled with genetic counseling and closed-loop management. It is suggested to use this integrated method as an improved strategy instead of the current limited genetic screening program in some regions of China.

Call for equitable hearing healthcare provision: an exploration of Māori adults’ perspectives and lived experiences of ear and hearing healthcare services in Te Waipounamu

ABSTRACT Māori adults are over-represented in self-reported hearing loss statistics in Aotearoa, yet they are currently underserved in hearing healthcare services that were designed using one-size-fits-all Eurocentric ideologies and models of health and disability. Unassisted hearing loss has been linked to increased rates of depression, social isolation, communication issues, early retirement, and cognitive decline, as well as a decreased ability to engage with cultural practices. An area that requires further research is the exploration of Māori adults’ perspectives and experiences of hearing healthcare. This article uses a Kaupapa Māori lens to bring forward Māori narratives and expands on previous research of a te reo Māori hearing screening test. The article shares findings from interviews with Māori adults, exploring both their perspectives and lived experiences of ear and hearing healthcare and te reo hearing assessments. It highlights the barriers that exist for Māori when accessing hearing healthcare in Te Waipounamu (The South Island of Aotearoa) and the desire to see transformative change in the hearing healthcare landscape.

Wernicke Encephalopathy Presenting With Hearing Loss and Vision Loss in a Nonalcoholic Patient

Wernicke Encephalopathy Presenting With Hearing Loss and Vision Loss in a Nonalcoholic Patient