Hearing Scale Research Articles

Job satisfaction and quality of life in adult users of bone conduction hearing devices pre-and post-implantation: a 1-year follow-up study

Objective Hearing loss is a growing public health issue that significantly impacts both health-related quality of life and working life. This study investigates how hearing rehabilitation with bone conduction hearing implants impacts health-related quality of life and working life in adults of working age with hearing impairment. Design This longitudinal study used data from Cochlear’s Implant Recipient Observational Study to assess hearing disabilities and job satisfaction in 18–65-year-old recipients of bone conduction hearing implants. Baseline data were collected pre-implantation and patients were followed-up at 12-months post-implantation. Study sample Patient demographics, Health Utilities Index Mark 3, the Speech Spatial and Qualities of Hearing Scale, and self-reported employment data are presented for a sample ranging from 30 to 43 patients, pre-implantation and at 12-months follow-up following implantation with a bone conduction hearing implant. Results Significant improvements in hearing and speech attribute, and overall health-related quality of life were observed between pre-and post-implantation. Overall hearing disability decreased post-implantation and job satisfaction improved. Conclusions Hearing rehabilitation using bone conduction hearing implants are shown to improve health-related quality of life, reduce hearing disability, and improve work performance and satisfaction. Results are representative of healthy and actively working users of bone conduction hearing implants.

Dificuldades de adultos ouvintes em situações cotidianas de escuta

ABSTRACT Purpose: to verify hearing difficulties related to everyday listening situations self-reported by normally-hearing adults. Methods: a cross-sectional observational study in which adult individuals with clinically normal hearing, verified through audiometry and tympanometry, were included. The participants answered the Brazilian Portuguese version of the Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire. Statistical analysis comprised descriptive and Spearman’s correlation test with a significance level of 5%. Results: the sample consisted of 28 participants, aged between 20 and 44 years. The median SSQ score was 8.75, in the Hearing to Speech domain, 8.11, in the Spatial Hearing domain, and 8.91, in the Quality-of-Hearing domain. There was an association between the participant's age and the score on five questions, demonstrating less self-reported difficulty as age increased. Conclusion: difficulties in everyday listening situations, self-reported by normally-hearing adults, participating in this study, were more related to situations with competitive noise and listening effort.

Development of an Internet-based system to guide and telemonitor hearing aid users.

To develop and verify the usability of an internet-based system for telemonitoring and guidance of the hearing aid user as well as monitoring the long-term performance in a pilot group. The system "I can hear, but I can't understand" was developed based on recommendations in the literature regarding layout, design, and content for guidance and advice. Three stages were followed: planning, design and content development, and pilot testing. The sample consisted of 43 adults and older adults with any type and degree of hearing loss, who had been regularly using a hearing aid for at least 30 days and at most 24 months, with reading skills and no evidence of cognitive impairments. The individuals were followed up for 8 to 12 months. The users' performance was monitored with the Speech, Spatial and Qualities of Hearing Scale. The usability of this material was assessed with the System Usability Scale. Improved performance and increased self-reported daily use of the hearing aid were observed after the period of guidance and telemonitoring via the system for all research participants. In all analyzes of the SUS scale, it was possible to observe a performance superior to 70 points, demonstrating good usability of the system. In the analysis of the performance of the SSQ, in the three moments of the research, a positive response was observed in all domains, thus showing progress in the use of hearing aids, with significant data for the domain of Hearing Speech. The system "I can hear, but I can't understand" proved to be an easy-to-use and effective tool to telemonitor hearing aid users.

Treinamento auditivo cognitivo em sujeitos após COVID-19: uma análise dos efeitos da intervenção em adultos

ABSTRACT Purpose To analyze the effectiveness of a therapeutic intervention plan through an existing cognitive auditory training program, adapted for adults, after one year of COVID-19 infection. Methods 13 subjects, between 18 and 59 years old, four males and nine females participated in the study. All underwent anamnesis, visual inspection of the external acoustic meatus, pure tone audiometry, speech audiometry and acoustic immitance measurements as selection procedures. For the research, the following procedures were carried out in the evaluation and reassessment: evaluation of central auditory processing, brief neuropsychological evaluation - NEUPSILIN, Speech, Spatial and Qualities of Hearing Scale and the Cognitive Potential - P300 with speech stimulus. Cognitive auditory training was carried out in six consecutive sessions, in an open field, lasting approximately 50 minutes. In all analyses, a significance level of 5% (p≤0.05) was considered. Results When comparing the variables between the periods, pre and post intervention, there was a statistically significant difference in the Dichotic Digit Test (p = 0.009), in the Frequency Pattern Test (p = 0.020) and in Speech, Spatial and Qualities of Hearing Scale (p = 0.001). And a tendency to significance (p < 0.10) in the Gap in Noise test and Total Attention. Conclusion Cognitive auditory training proved to be an effective therapeutic strategy for the treatment of adults with speech comprehension and cognition complaints after COVID-19 infection.

Desenvolvimento de sistema baseado na internet para orientação e telemonitoramento de usuários de prótese auditiva

ABSTRACT Purpose To develop and verify the usability of an internet-based system for telemonitoring and guidance of the hearing aid user as well as monitoring the long-term performance in a pilot group. Methods The system “I can hear, but I can’t understand” was developed based on recommendations in the literature regarding layout, design, and content for guidance and advice. Three stages were followed: planning, design and content development, and pilot testing. The sample consisted of 43 adults and older adults with any type and degree of hearing loss, who had been regularly using a hearing aid for at least 30 days and at most 24 months, with reading skills and no evidence of cognitive impairments. The individuals were followed up for 8 to 12 months. The users’ performance was monitored with the Speech, Spatial and Qualities of Hearing Scale. The usability of this material was assessed with the System Usability Scale. Results Improved performance and increased self-reported daily use of the hearing aid were observed after the period of guidance and telemonitoring via the system for all research participants. In all analyzes of the SUS scale, it was possible to observe a performance superior to 70 points, demonstrating good usability of the system. In the analysis of the performance of the SSQ, in the three moments of the research, a positive response was observed in all domains, thus showing progress in the use of hearing aids, with significant data for the domain of Hearing Speech. Conclusion The system “I can hear, but I can’t understand” proved to be an easy-to-use and effective tool to telemonitor hearing aid users.

Evaluation of self-esteem in hearing aid and cochlear implant users.

We investigated the relationship between hearing aid or cochlear implant use and self-esteem, quality of life, hearing quality, and speech perception. Of the 120 participants studied, 29 were cochlear implant users, 26 were hearing aid users, 33 were non-device users with hearing loss, and 32 had normal hearing. Each individual included in the study WHOQOL-BREF Quality-of-Life Scale, Rosenberg Self-Esteem and Speech, Spatial Perception and Qualities of Hearing Scale was applied. We found that the self-esteem level of the group with hearing loss, but without a device, was significantly lower than that of the group with a cochlear implant/hearing aid. There was a moderately statistically significant relationship between self-esteem, quality of life, speech perception, and hearing quality. Using hearing aid and cochlear implants increases self-esteem among people with hearing impairments. Self-esteem is associated with quality of life, speech perception, and hearing quality.

Development of the hearing-related quality of life questionnaire for auditory-visual, cognitive and psychosocial functioning (hAVICOP)

IntroductionThere is a need for a validated and standardized self-assessment instrument to assess the subjective effect of hearing aid (HA) use and/or cochlear implantation (CI) on different aspects of functioning in daily life. The aim of this study was to develop a new holistic Patient Reported Outcome Measure (PROM) to assess hearing-related quality of life. The new PROM is titled the hearing-related quality of life questionnaire for Auditory-VIsual, COgnitive and Psychosocial functioning (hAVICOP). MethodsA conceptual framework was set up and test items were prepared per domain. Preliminary testing involved a semi-structured interview-based assessment in normal-hearing and hearing-impaired adults and an expert panel. For the further psychometric evaluation, a new sample of 15 adult HA users, 20 adult CI users and 20 normal-hearing adults filled in the refined version of the hAVICOP, the Speech, Spatial and Qualities of Hearing Scale, the Nijmegen Cochlear Implant Questionnaire and the TNO-AZL Questionnaire for Adult's Health-Related Quality of Life. Based on these results, a factor analysis was conducted and internal consistency, discriminant validity and concurrent construct validity were determined. ResultsThe final version of the hAVICOP consists of three domains for hearing-related quality of life: (1) auditory-visual functioning, (2) cognitive functioning, and (3) psychosocial functioning. A sufficient internal consistency was found, and discriminant validity and concurrent construct validity were good. ConclusionsA new PROM to assess hearing-related quality of life was developed, named the hAVICOP. In the future the validity and reliability should be examined further.

Study protocol for a randomised controlled trial evaluating the benefits from bimodal solution with cochlear implant and hearing aid versus bilateral hearing aids in patients with asymmetric speech identification scores

IntroductionCochlear implant (CI) and hearing aid (HA) in a bimodal solution (CI+HA) is compared with bilateral HAs (HA+HA) to test if the bimodal solution results in better speech intelligibility and...

Functional consequences of extended high frequency hearing impairment: Evidence from the speech, spatial, and qualities of hearing scale.

Hearing loss in the extended high frequencies, despite a normal audiogram, could affect speech-in-noise recognition. However, it is not known if extended high frequency (EHF) hearing loss is associated with everyday listening and communication deficits. The present study aimed to determine the functional effects of impaired EHF hearing among adults using the Speech, Spatial, and Qualities of Hearing Scale (SSQ). A secondary objective was to evaluate the relationship between objective (speech-in-noise recognition) and subjective (SSQ) measures of hearing function. Listeners with EHF hearing loss provided lower SSQ ratings compared with their EHF-normal counterparts. The lower ratings could not be attributed to the age or standard audiogram of the listeners. Ratings from more than 50% of EHF-impaired listeners were below the 2 SD cutoff point obtained from EHF-normal listeners. The mean speech recognition threshold was poorer for EHF-impaired listeners, and a poorer speech recognition threshold was associated with lower SSQ ratings, i.e., poorer self-reported hearing ability. For some listeners, EHF hearing loss could be the missing link between self-reported hearing difficulty in the presence of a normal audiogram. These findings provide evidence for the functional deficits associated with EHF hearing loss and invoke the need for future investigations into the management of EHF loss.

Treated large posterior fossa vestibular schwannoma and meningioma: Hearing outcome and willingness-to-accept brain implant for unilateral deafness.

To compare functional hearing and tinnitus outcomes in treated large (~ 3 cm) vestibular schwannoma (VS) and posterior fossa meningioma cohorts, and construct willingness-to-accept profiles for an experimental brain implant to treat unilateral hearing loss. A two-way MANOVA model with two independent variables (tumor type; time from treatment) and three dependent variables (hearing effort of tumor ear; abbreviated Speech, Spatial, and Qualities of Hearing scale (SSQ12); Tinnitus Functional Index (TFI)) was used to analyze data from VS (N=32) and meningioma (N=50) patients who were treated at a tertiary care center between 2010 and 2020. A query to probe acceptance of experimental treatment for hearing loss relative to expected benefit was used to construct willingness-to-accept profiles. Tumor type was statistically significant on the combined dependent variables analysis (F[3, 76]=19.172, p < .0005, Wilks' Λ=0.569). Meningioma showed better outcome for hearing effort (F[1, 76]=14.632, p < .0005) and SSQ12 (F[1, 76]=16.164, p < .0005), but not for TFI (F[1, 76]=1.247, p=.268) on univariate two-way ANOVA analyses. Superior hearing effort and SSQ12 indices in the short-term (< 2 years) persisted in the long-term (> 2 years) (p ≤ .017). At the 60% speech understanding level, 77% of respondents would accept an experimental brain implant. Hearing outcome is better for posterior fossa meningioma compared to VS. Most patients with hearing loss in the tumor ear would consider a brain implant if the benefit level would be comparable to a cochlear implant. 2.

Cochlear Implants for Single-Sided Deafness: Quality of Life, Daily Usage, and Duration of Deafness.

To report our experience for adults undergoing cochlear implantation (CI) for single-sided deafness (SSD). This is a retrospective case series for adults with SSD who underwent CI between January 2013 and May 2021 at our institution. CNC and AzBio speech recognition scores, Tinnitus Handicap Inventory (THI), Speech, Spatial, and Qualities of Hearing Scale (SSQ12), datalogging, and the Cochlear Implant Quality of Life (CIQOL)-10 Global measure were utilized. Sixty-six adults underwent CI for SSD (median 51.3 years, range 20.0-74.3 years), and 57 (86.4%) remained device users at last follow-up. Compared to pre-operative performance, device users demonstrated significant improvement in speech recognition scores and achieved peak performance at six months post-activation for CNC (8.0% increased to 45.6%, p < 0.0001) and AzBio in quiet (12.2% increased to 59.5%, p < 0.0001). THI was decreased at 6 months post-implantation (58.1-14.6, p < 0.0001), with 77% of patients reporting improved or resolved tinnitus. Patients demonstrated improved SSQ12 scores as well as the disease-specific CIQOL-10 Global questionnaire. Duration of deafness was not associated with significant differences in speech recognition performance. Average daily wear time was positively associated with CNC and AzBio scores as well as post-operative CIQOL-10 scores. Herein we present the largest cohort of adult CI recipients with SSD with data on speech recognition scores, tinnitus measures, and SSQ12. Novel insights regarding the correlation of datalogging, duration of deafness, and CI-specific quality of life (CIQOL-10) metrics are discussed. Data continue to support CI as an efficacious treatment option for SSD. 4 Laryngoscope, 133:2362-2370, 2023.

Single-Sided Deafness: Emotional and Social Handicap, Impact on Health Status and Quality of Life, Functional Hearing, and the Effects of Cochlear Implantation.

To evaluate the functional and subjective outcomes in individuals with single-sided deafness (SSD) treated with a cochlear implant (CI). Eighty-one adult CI users with SSD participated in this study. Functional assessments consisted of speech in noise testing and localization. Subjective assessments consisted of the Speech Spatial Quality of Hearing Scale, the Tinnitus Reaction Questionnaire, the Abbreviated Profile of Hearing Aid Benefit questionnaire, the Hearing Handicap Inventory for Adults questionnaire, and the Glasgow Health Status Inventory and the Glasgow Benefit Inventory questionnaires. SSD has remarkable consequences on quality of life (QoL) and imposes a substantial emotional and social handicap on the individuals. Self-reported QoL improved after CI with tinnitus intrusion significantly reduced as early as 3 months post-CI. A significant improvement was seen in all speech understanding in noise configurations. Localization ability significantly improved with CI on. Our findings demonstrate that SSD reduces social and psychological QoL and imposes a remarkable level of handicap as per general and specific self-assessments tool. CI provided a significant improvement in function including speech understanding in noise and localization ability, as well as improved QoL and reduced tinnitus significantly in both the early and long terms.

Further Evidence for Individual Ear Consideration in Cochlear Implant Candidacy Evaluation.

To report speech outcomes after cochlear implantation (CI) for asymmetric hearing loss (AHL) and assess the influence of contralateral hearing. Retrospective review. Tertiary referral center. One hundred eighty-eight adults (mean age, 70 yr) undergoing CI for AHL from 2015 to 2020. Candidacy included pure-tone average (PTA) at least 70 dB hearing level and AzBio in quiet 60% or less in the implanted ear and AzBio in quiet greater than 40% in the contralateral ear. PTA; Consonant-Nucleus-Consonant (CNC) word, AzBio sentences scores; Speech, Spatial, and Qualities of Hearing Scale (SSQ). Mean preoperative PTA and AzBio in the implanted and contralateral ears were 85.2 and 68.1 dB hearing level and 24.7% and 69.2%, respectively. Mean CNC in the implanted ear increased from 18.3% preoperatively to 44.4% ( p < 0.0001) at 6 months and 49.3% ( p < 0.0001) at 12 months. Mean AzBio in the implanted ear improved from 24.7% preoperatively to 60.3% ( p < 0.0001) at 6 months and 64.3% ( p < 0.0001) at 12 months. Patients demonstrated significant improvement in all SSQ domains at 6 and 12 months. When comparing patients with preoperative contralateral AzBio greater than 60% versus 41% to 60%, no significant differences existed in postoperative CNC scores (6-mo: 47% versus 41%, p = 0.276; 12-mo: 51% versus 47%, p = 0.543). There were no significant differences in 6-month ( p = 0.936) or 12-month ( p = 0.792) CNC scores between patients with AHL (contralateral ear AzBio >40%) and 169 unilateral CI patients meeting the traditional Medicare criteria (contralateral ear AzBio ≤40%). CI recipients with AHL derive significant speech improvements, supporting individual ear consideration for CI candidacy and patient benefit outside of current Medicare criteria.

A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery-Are We Doing Better?

To characterize the influence of expanding indications on the profile of adults undergoing cochlear implantation (CI) at a high-volume CI center. Retrospective review. Tertiary referral center. 774 adults undergoing CI evaluation from August 2015 to August 2020. Demographics; audiometry; speech recognition; speech, spatial, and qualities of hearing scale (SSQ-12). Of 745 (96.3%) patients qualifying for implantation, 642 (86.6%) pursued surgery. Median age at evaluation was 69 years; 56.3% were men; 88.2% were Caucasian. Median distance to our center was 95 miles. The majority (51.8%) had public insurance (Medicare, Medicaid), followed by private (47.8%) and military (0.4%). Mean PTA, CNC, and AzBio in quiet and noise for the ear to be implanted were 85.2 dB HL, 15.0%, and 19.2% and 3.5%, respectively. Hybrid/EAS criteria were met by 138 (18.5%) CI candidates, and 436 (77.0%) unilateral CI recipients had aidable contralateral hearing for bimodal hearing configurations. Younger age (odds ratio [OR], 0.96; 95% confidence interval, 0.93-0.99) and non-Caucasian race (OR, 6.95; 95% confidence interval, 3.22-14.98) predicted candidacy. Likelihood of surgery increased for Caucasian (OR, 8.08; 95% confidence interval, 4.85-13.47) and married (OR, 2.28; 95% confidence interval, 1.50-3.47) patients and decreased for those with public insurance (OR, 0.45; 95% confidence interval, 0.29-0.69). A lower SSQ-12 score predicted both candidacy and surgery. Despite expansions in criteria, speech understanding remained extremely low at CI evaluation. Younger age and non-Caucasian race predicted candidacy, and Caucasian, married patients with private insurance and lower SSQ scores were more likely to pursue surgery.

Influence of tinnitus annoyance on hearing-related quality of life in cochlear implant recipients

Tinnitus is a common symptom in cochlear implant (CI) recipients. There is no clear evidence of the influence of tinnitus on hearing-related quality of life (QoL) in this population. The aim of this study was to assess the relationship between hearing-related QoL measured by the Speech, Spatial and Qualities of Hearing scale (SSQ12) and tinnitus annoyance or perceived change in tinnitus annoyance after cochlear implantation. The study sample consisted of 2322 implanted adults across France, Germany, Ireland, Italy, the Netherlands, Sweden and the United Kingdom. Information relating to QoL measured using the SSQ12 and tinnitus annoyance and change in tinnitus annoyance, assessed using single-item questions, were collected one or more years post-implantation. The relationship between SSQ12 score and tinnitus annoyance or change in tinnitus annoyance was analysed using linear models adjusted for age and unilateral versus bilateral implants. Tukey pairwise tests were used to compare mean SSQ12 scores across levels of tinnitus annoyance and changes. Tinnitus prevalence was 33.9% post-implantation. Recipients with tinnitus had a significantly lower SSQ12 score than recipients without tinnitus. SSQ scores varied significantly with tinnitus annoyance, age and unilateral versus bilateral implants. Overall, CI recipients who experienced less bothersome tinnitus reported better hearing-related QoL. Healthcare professionals should be aware of the influence of tinnitus on CI recipients’ hearing to manage patient expectations.

Image-Guided Cochlear Implant Programming: A Systematic Review and Meta-analysis.

To review studies evaluating clinically implemented image-guided cochlear implant programing (IGCIP) and to determine its effect on cochlear implant (CI) performance. PubMed, EMBASE, and Google Scholar were searched for English language publications from inception to August 1, 2021. Included studies prospectively compared intraindividual CI performance between an image-guided experimental map and a patient's preferred traditional map. Non-English studies, cadaveric studies, and studies where imaging did not directly inform programming were excluded. Seven studies were identified for review, and five reported comparable components of audiological testing and follow-up times appropriate for meta-analysis. Demographic, speech, spectral modulation, pitch accuracy, and quality-of-life survey data were collected. Aggregate data were used when individual data were unavailable. Audiological test outcomes were evaluated as standardized mean change (95% confidence interval) using random-effects meta-analysis with raw score standardization. Improvements in speech and quality-of-life measures using the IGCIP map demonstrated nominal effect sizes: consonant-nucleus-consonant words, 0.15 (-0.12 to 0.42); AzBio quiet, 0.09 (-0.05 to 0.22); AzBio +10 dB signal-noise ratio, 0.14 (-0.01 to 0.30); Bamford-Kowel-Bench sentence in noise, -0.11 (-0.35 to 0.12); Abbreviated Profile of Hearing Aid Benefit, -0.14 (-0.28 to 0.00); and Speech Spatial and Qualities of Hearing Scale, 0.13 (-0.02 to 0.28). Nevertheless, 79% of patients allowed to keep their IGCIP map opted for continued use after the investigational period. IGCIP has potential to precisely guide CI programming. Nominal effect sizes for objective outcome measures fail to reflect subjective benefits fully given discordance with the percentage of patients who prefer to maintain their IGCIP map.

Listening effort in patients with sensorineural hearing loss with and without hearing aids

BackgroundPersons with hearing loss may have difficulty in speech understanding, so they need to shift more resources from other on-going cognitive tasks. This increase in cognitive resources has been referred to as an increase in “listening effort: (LE). Two research questions were addressed: (Q1) Does hearing loss increase LE? (Q2) Can hearing aid (HA) amplification improve LE?MethodsThis study included 55 subjects that were divided into two groups: control group (I), which consisted of 15 adults with normal peripheral hearing, and study group (II), which consisted of 40 patients with bilateral SNHL. They were subdivided into two subgroups: study subgroup (IIa), which consisted of 20 patients did not use (HAs). The study subgroup (IIb) consisted of 20 patients using unilateral or bilateral HAs. LE was measured by subjective (Speech, Spatial and Qualities of Hearing Scale (SSQ), Fatigue Assessment Scale (FAS)) and behavioral measures (dual-task paradigm test (simultaneous primary auditory task (QuickSIN test) and secondary visual task (reaction time and Stroop test)).ResultsHearing loss patients showed higher fatigue scores and lower scores in SSQ than the normal hearing subjects. They also showed significantly longer reaction times (RTs) in dual conditions. No significant difference was found between patient with SNHL with and without HAs in all tests.ConclusionPatients with SNHL with and without HAs showed more LE than the normal hearing subjects (Q1). Hearing aid fitting does not reduce LE (Q2). HA users showed less listening effort in favorable listening situation (higher signal-to-noise ratio) than those who did not use HAs. Increased LE is a consequence of hearing loss which could not be measured by standard audiometric measures, so it should be considered when measuring disability in those with hearing loss.

Impact of an Endolymphatic Sac Tumor on Subjective and Objective Audiovestibular Function.

This study reports subjective and objective audiovestibular function in patients diagnosed with an endolymphatic sac tumor (ELST), to evaluate the clinical implication of vestibular testing in ELST patients. Retrospective cohort study. Tertiary referral center/university hospital. Five patients diagnosed with unilateral ELST. Subjective and objective audiovestibular tests; pure-tone average; speech discrimination score; the Video Head Impulse Test; the cervical vestibular evoked myogenic potential test; the caloric irrigation test; the Speech, Spatial and Qualities of Hearing Scale; the Tinnitus Handicap Inventory; and the Dizziness Handicap Inventory. Findings and characteristics of both subjective and objective audiovestibular functions. The mean pure-tone average and the mean speech discrimination score were 49 dB HL and 68% on the tumor ear and 13 dB HL and 99% contralaterally. The mean Speech, Spatial and Qualities of Hearing Scale score was 84, and the mean Tinnitus Handicap Inventory score was 64. Caloric testing showed a mean unilateral weakness of 80%. The Video Head Impulse Test of the lateral semicircular canal revealed refixation saccades on all tumor ears and an average gain value of 0.75 on the tumor ear versus 0.94 contralaterally. No cervical vestibular evoked myogenic potentials were elicited on the tumor side, whereas all but one was elicited contralaterally. The average Dizziness Handicap Inventory score was 47. A characteristic pattern of abnormal caloric findings, refixation saccades, and normal vestibulo-ocular reflex gain alongside sensorineural hearing loss on the tumor ear was identified. Asymmetric sensorineural hearing loss in any patient should lead to objective vestibular evaluation to strengthen not only a targeted tumor surveillance strategy and the indication for imaging, but also the design of vestibular rehabilitation. In addition, vestibular findings may guide the choice of surgical approach.

Cochlear Implantation in Young Mandarin-Speaking Children: One Year After First Fitting.

Bilateral cochlear implantation has been shown to be beneficial in terms of sound localization and speech recognition in children with congenital deafness. However, little is known about the benefits of bilateral cochlear implantationin children who communicate in a tonal language such as Mandarin. This study aims to investigate the auditory perception and speech intelligibility of Mandarin-speaking children 1 year after first fitting. Twenty-nine children aged between 11.5 and 17.9 months with severe-to-profound bilateral sensorineural hearing loss were recruited; 10 were unilaterally implanted and 19 were bilaterally implanted. A test battery was used to monitor improvements during the first year of cochlear implant use. Bilaterally implanted children scored better in the spatial domain of the Speech, Spatial and Qualities of hearing scale for Parents (SSQ-P) in comparison to unilaterally implanted children. Significant improvements were observed in auditory performance and speech intelligibility at 6 and 12 months after first fitting for both groups of children. Young children that speak a tonal language, such as Mandarin, can obtain significant improvements in hearing and speech abilities within the first year of cochlear implant use. Furthermore, bilateral implantation provides users with better spatial hearing in comparison to unilateral implantation.

Musical Training and Its Association With Age-Related Changes in Binaural, Temporal, and Spatial Processing.

This article aimed to assess the relationship between musical training and age-related changes in binaural, temporal, and spatial processing abilities. A standard group comparison study was conducted involving both musicians and nonmusicians. The effect of musical training was assessed using a battery of psychoacoustical tests (interaural time and level difference thresholds: ITD & ILD, binaural gap detection threshold, and virtual auditory space identification test) and subjective ratings (Spatial-Hearing subsection of Speech, Spatial, and Quality of Hearing scale in Kannada). A total of 60 participants, between 41 and 70 years, were divided into three groups of 20 each, based on their age (41-50, 51-60, and 61-70 years). Each of these three groups was subdivided into two, one comprising 10 musicians (vocalists practicing South-Indian classical music) and the other comprising 10 nonmusicians. Multivariate analyses of variance revealed that musicians performed significantly better (p < .001) than nonmusicians in all the tests. Analyses of variance showed that whereas age had no effect (p > .05) on performance in any of the tests in musicians, age affected the performance of nonmusicians significantly in terms of ITD (p = .02) and ILD (p = .01) thresholds. Musical training appears to have the potential to slow down age-related decline in binaural, temporal, and spatial processing.