Rehabilitation Of Hearing Loss Research Articles

Early assessment of communicative competence in children with hearing loss using the Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE) method

PurposeThis work presents a new frame-by-frame video analysis method called Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE), developed in the context of pediatric hearing loss as a rehabilitation tool for assessing children's early communication skills. CC-CARE stems from the commonly used Tait video analysis and extends it by including a new set of parameters aimed at disentangling between hearing-dependent and hearing-independent aspects of communication. Method: In this paper, we collected video samples of child-caregiver interactions in a group of 65 normal-hearing children and a group of 165 hearing-impaired children. For each group, we present the CC-CARE method and describe the parameters, their score distributions, correlations and we estimate the adherence of the CC-CARE scores with children's developmental trajectory. Moreover, we compare the results of CC-CARE scores between the two groups having had different development of the auditory system. Finally, a fully-data driven approach was employed to assess the consistency of the communicative efficacy index (CEI), a score aiming to capture a global result of the CC-CARE procedure. Results: Correlations among parameter scores were found in each within-group analysis, revealing CC-CARE's internal consistency in measuring associated but nonoverlapping communication dimensions. For both groups, CC-CARE scores were associated with participants' age. Differences between scores emerged for a between-group analysis, indicating CC-CARE sensitivity to extract communication differences as a function of the hearing status. For both groups, the data analysis revealed that the CEI captures large variance portions across all parameter scores of the CC-CARE method. Conclusions: Results provide the first evidence that the CC-CARE video analysis method could be a reliable tool capable of highlighting the cascading effects of hearing impairment on children's preverbal communicative efficacy. The CC-CARE method aims to support early rehabilitation of hearing loss by describing a child's communicative efficacy.

Bursts of vagus nerve stimulation paired with auditory rehabilitation fail to improve speech sound perception in rats with hearing loss

Hearing loss can lead to long-lasting effects on the central nervous system, and current therapies, such as auditory training and rehabilitation, show mixed success in improving perception and speech comprehension. Vagus nerve stimulation (VNS) is an adjunctive therapy that can be paired with rehabilitation to facilitate behavioral recovery after neural injury. However, VNS for auditory recovery has not been tested after severe hearing loss or significant damage to peripheral receptors. This study investigated the utility of pairing VNS with passive or active auditory rehabilitation in a rat model of noise-induced hearing loss. Although auditory rehabilitation helped rats improve their frequency discrimination, learn novel speech discrimination tasks, and achieve speech-in-noise performance similar to normal hearing controls, VNS did not enhance recovery of speech sound perception. These results highlight the limitations of VNS as an adjunctive therapy for hearing loss rehabilitation and suggest that optimal benefits from neuromodulation may require restored peripheral signaling.

Bone Conduction Implants: Comparative of Audiometric Results and Quality-of-Life Bonebridge® versus Osia®

Introduction: Bone conduction implants have been indicated for patients with conductive hearing loss, mixed hearing loss, and even profound unilateral sensorineural hearing loss. With the introduction of Bonebridge®, new transcutaneous implant options emerged. The latest is Osia®, a direct-drive variant or active systems, where the implant directly generates and applies vibration to the bone. Materials and Methods: Retrospective study of two cohorts of patients treated with active bone conduction implants at a single center, one with the Bonebridge® device and the other with Osia®. Outcomes: Fourteen patients were included, seven in each group (n = 14). The Bonebridge® group showed an average hearing gain in tonal intelligibility thresholds of 32.43 ± 21.39 dB and a gain in the average intelligibility threshold (with 50% discrimination) of 26.29 ± 19.10 dB. In the Osia® group, there was a gain in average tonal thresholds of 41.49 ± 14.16 dB and 23.72 ± 6.98 dB in average intelligibility thresholds. Both devices contributed to improvements in patients’ quality of life, as assessed with APHAB in all the variables studied in the test. Both devices offer rehabilitation for hearing loss as an alternative to hearing aids. The Osia® system shows statistically significant (p ® slightly outperforms in speech understanding at 50%. Differences in average tonal thresholds and quality of life are not statistically significant. Conclusions: While auditory improvement is observed postimplantation, other aspects, such as intelligibility thresholds and quality of life, lack statistical significance. Given the limited experience with Osia® and the small sample size, the choice of the device should be personalized. Although the literature is inconsistent due to small sample sizes and variable approaches, some studies suggest potential advantages of the Osia® system, especially in speech comprehension in different environments and greater hearing gain compared to Bonebridge®.

A study to evaluate the burden of hearing loss and its correlation with risk factors among high-risk infants at a teaching institution, Jaipur.

Hearing loss is a global issue of hearing disability and early detection and rehabilitation of hearing loss are important for the development of speech and language skills in hearing-impaired infants. There are multiple risk factors that aid in hearing loss but some are potential factors that contribute toward hearing loss in infants. The aim of this study was to assess the burden of hearing loss and its correlation with risk factors among high-risk infants at a teaching institution in Jaipur, Rajasthan. This study was carried out after approval of institutional ethics committee on a total of 320 high-risk infants at RUHS College of medical sciences and associated hospitals. Hearing loss was assessed by brainstem evoked response audiometry (BERA). Statistical analysis of data was done by cross-tabulation analysis with Pearson correlation and quantile regression. Out of 320 high-risk infants, 59.69% of infants had normal hearing, 9.09% Unilaterally hearing impaired, 20.31% were bilaterally mild-moderate hearing loss, and 10.94% had severe-profound deafness. The prevalence of important risk factors viz. hyperbilirubinemia, low birth weight, appearance, pulse, grimace, activity, and respiration score, meconium aspiration, respiratory distress, and ventilation greater than five days were 86%, 58.9%, 40%, 36%, 29%, and 22%, respectively. In high-risk infants, hearing loss is a common hearing disorder. Because of this, early diagnosis of hearing loss gives them the best chance of developing functional speech. Brainstem evoked response audiometry is a simple, reliable, and effective technique for the assessment of auditory functions in infants.

The future of hearing aid technology : Can technology turn us into superheroes?

Hearing aid technology has proven to be successful in the rehabilitation of hearing loss, but its performance is still limited in difficult everyday conditions characterized by noise and reverberation. Introduction to the current state of hearing aid technology and presentation of the current state of research and future developments. The current literature was analyzed and several specific new developments are presented. Both objective and subjective data from empirical studies show the limitations of the current technology. Examples of current research show the potential of machine learning-based algorithms and multimodal signal processing for improving speech processing and perception, of using virtual reality for improving hearing device fitting and of mobile health technology for improving hearing health services. Hearing device technology will remain akey factor in the rehabilitation of hearing impairments. New technology, such as machine learning and multimodal signal processing, virtual reality and mobile health technology, will improve speech enhancement, individual fitting and communication training, thus providing better support for all hearing-impaired patients, including older patients with disabilities or declining cognitive skills.

Newborn Hearing Screening with Two-Step Protocol and Risk Factor Identification: Our Experience at a Tertiary Care Centre in Eastern India.

To estimate the prevalence of hearing loss and identify the high-risk factors among neonates with hearing loss. Retrospective study done on 1054 infants in a tertiary care centre in Eastern India from 2020 to 2021 and approved by the Institutional Ethics Committee. A two-step protocol is used for screening. In the well-nursed group, OAE and BOA were performed. In the case of REFER results for automated ABR following OAE evaluation in well-nursed babies, a detailed audiological evaluation was scheduled to be carried out using diagnostic ABR within one month of age. In the high-risk group, hearing screening includes OAE, BOA, and AABR evaluations. AABR evaluation was performed as a part of the screening protocol irrespective of the results of OAE screening as PASS or REFER. In our study among 1053 neonates screened, 375 were in the risk category, and 679 were without risk factors. The overall prevalence of hearing loss in neonates was 22.78 per 1000 screened neonates and 56 per 1000 among high-risk neonates. In the high-risk group, we were able to identify 4 cases of Auditory spectrum neuropathy disorder with the use of AABR during 1st step of screening. In multivariate regression analysis, the risk factors for hearing loss identified were NICU stay (OR = 3.6, 95% CI = 1.1-12.03) and Craniofacial anomalies (OR = 55.37, 95% CI = 16.48- 186.01). Early neonatal screening helps in the detection, intervention, and rehabilitation of hearing loss. The use of AABR in risk infant screening enhanced the chance of detection of auditory spectrum neuropathy disorder (ASND) cases. The online version contains supplementary material available at 10.1007/s12070-023-03723-3.

Evaluating the effectiveness of bone conduction hearing implants in rehabilitation of hearing loss.

Implantable hearing devices are indicated for candidates who could not benefit from conventional hearing aids. This study aimed at evaluating their effectiveness in rehabilitation of hearing loss. This study included patients who received bone conduction implants at Tertiary Teaching Hospitals, between December 2018 and November 2020. Data were collected prospectively, and patients were assessed both subjectively using COSI and GHABP questionnaires and objectively using bone conduction and air conduction thresholds, unaided and aided free field speech thresholds. Outcomes of transcutaneous (tBCHD) and percutaneous (pBCHD) bone conduction hearing devices were compared as well as outcomes of unilateral versus bilateral fitting. Postoperative skin complications were recorded and compared. A total of seventy patients were included, thirty-seven of them were implanted with tBCHD and thirty-three with pBCHD. Fifty-five patients were fitted unilaterally compared to 15 bilateral fitting. Preoperative mean of bone conduction (BC) of the overall sample was 23.27 ± 10.91dB, the Air conduction (AC) mean was 69.27 ± 13.75dB. There was significant difference between unaided free field speech score (88.51% ± 7.92) and the aided score (96.79 ± 2.38) with P value = 0.00001. The postoperative assessment using GHABP showed a benefit score mean of 70.95 ± 18.79, patient satisfaction score mean of 78.15 ± 18.39. The disability score improved significantly from a mean of 54.08 ± 15.26 to residual score of only 12.50 ± 10.22 with P < 0.00001 postoperatively. There was significant improvement in all parameters of COSI questionnaire following fitting. Comparison of pBCHDs vs tBCHDs showed a non-significant difference regarding FF speech as well as GHABP parameters. Comparison of the post-operative skin complications was in favor of tBCHDs as (86.5%) of the patients had normal skin postoperatively, compared to 45.5% of patients with pBCHDs devices. Bilateral implantation showed significant improvement of FF speech scores, GHABP satisfaction score, as well as COSI score results. Bone conduction hearing devices are effective solution for rehabilitation of hearing loss. Bilateral fitting yields satisfactory outcomes in suitable candidates. Transcutaneous devices carry significantly lower skin complication rates compared to percutaneous devices.

Wildervanck syndrome: Case report

Abstract BACKGROUND. Wildervanck syndrome was described for the first time in 1952. This rare entity is composed by the oculo-cervico-acoustic triad, which may be more or less complete. MATERIAL AND METHODS. We present a 5-year-old girl diagnosed with Wildervanck syndrome, exhibiting: Klippel-Feil anomaly (fused cervical vertebrae), Duane Stilling Turk syndrome (bilateral abducens palsy) and congenital bilateral cophosis indicated by ABR. RESULTS. The CT scan revealed major malformations of the brain and calvarium including the petrous part of both temporal bones. Despite all these brain malformations, the psychological development of the child was nearly normal. As it was previously reported in other cases, the child also presented spina bifida cervicalis and cleft palate. The cause of deafness was bilateral lack of cochleae, making impossible the insertion of the cochlear electrode for hearing rehabilitation. When the patients are discovered late (after 3 years of age), the management of hearing loss is by being taught sign language and lip reading. CONCLUSION. Any cranio-facial malformation and any delay in speech production impose early attention of the otorhinolaryngologist or audiologist for timely diagnosis and rehabilitation of hearing loss. The imaging examination, especially the high-resolution temporal bone CT-scan, is of paramount importance to be performed in all profound congenital deaf children to evaluate the candidacy to cochlear implantation.

Features and results of surgical rehabilitation of hearing loss in osteogenesis imperfecta

To evaluate the features and results of surgical rehabilitation of hearing loss in patients with osteogenesis imperfecta. During the period from 2009 to 2022, 2221 primary stapedoplasty was performed in the department, of which 23 (1.04%) in 21 patients were performed in patients with OI. There were 14 women and 7 men. According to TPA, bilateral hearing loss was detected in 19 patients and unilateral in 2. Conductive hearing loss was observed in 9 cases and mixed - in 14. The average thresholds for bone conduction (BC) were 22.7±8.04 dB, and the bone-air interval (ABG) - 36.1±5.3 dB. According to CT of the temporal bones, all patients showed a bilateral and symmetrical decrease in the density of the auditory ossicles, and in 7 patients there were extensive areas of non-uniform decrease in the density of the bone labyrinth up to +500 - +1000 HU.21 patients underwent 23 operations: in 21 cases stapedoplasty with laser assistance and in 2 cases ossiculoplasty. BC thresholds 6 months after surgery averaged 24.6±8.2 dB, and ABG - 12.1±2.9 dB. Closing of ABG ≤10 dB at spoken frequencies was detected in 30.5%, ABG ≤20 dB - in 95%. After 12 months or more after the operation, no change in the audiological parameters was noted. Stapes surgery for conductive and mixed hearing loss in OI patients is functionally effective. The best results are achieved after therapy with bisphosphonates with preparations of sodium fluoride, calcium and vitamin D, performing the operation when the density of demineralization zones reaches 1000 HU and using laser assistance. Taking into account the demineralization of the bone structures of the temporal bone, it is recommended to use autocartilaginous stirrup prostheses to restore sound conduction or to cover the attachment area of other prostheses with autologous tissues to prevent necrosis of the long stalk of the incus and stabilize long-term functional results.

Community-based assessment and rehabilitation of hearing loss: A scoping review.

Although the World Health Organization (WHO) recommends the use of a Community-Based Rehabilitation (CBR) model, little is known about how CBR has been applied in the hearing healthcare setting. The purpose of this scoping review was to identify and describe studies on Community-Based Hearing Rehabilitation (CBHR) programs within the applied context. The review was conducted in September 2020 with updated searches in November 2021 according to the Joanna Briggs Institute (JBI) methodology and reported using the guidelines and checklist for Preferred Reporting Items for Systematic Reviews and Meta Analyses-Extension for Scoping Reviews (PRISMA-ScR). Fifty-nine peer-reviewed research articles were included in the review. A narrative synthesis was conducted to map out the types of CBHR programs. Studies were classified into audiological themes: awareness, screening and assessment of hearing in newborn/infants, children and adults, training of community health workers, rehabilitation, cost-effectiveness and describing the service delivery models. Further categorisation was made based on CBR aspect matrices for each study. Most of the studies come from high-income countries in North America and Europe. CBHR studies predominantly focused on creating awareness, training and hearing screenings and/or assessments in communities and evaluating effectiveness in providing knowledge and access to hearing health services in rural or underserved communities. Further work is needed to examine the outcomes and effectiveness of CBHR using controlled studies. Moreover, more work is needed in low- and middle-income countries where the application of CBHR is critical for increased access and affordability.

History of the World Hearing Day

Background According to recent data from the World Health Organization from 2019, approximately 466 million people are living with a disabling hearing loss, most of them in low- and middle-income countries. Undiagnosed and untreated hearing disorders are proven to be a leading cause for morbidity and cost annually $750 billion. Hearing disorders and hearing loss are believed to higher their prevalence due to the fact that a wide majority of people are exposed to high noises and lack of timely and adequate hearing diagnostics and treatment of ear conditions. Methods Scientific databases – PubMed, SCOPUS and MEDLINE were used to search for the information targeted. The following keywords – World Hearing Day, history, events, prophylaxis, hearing disorders were used. Information from the official websites of the societies involved in celebrating World Hearing Day was included as well. The aim of the following article is to study the history of the event from its foundation till today, aiming to stress out its usefulness. Results and discussion Back in 1995, World Health Assembly passed a resolution WHA48.9, in which attention of the health impact of hearing loss was put – 120 million people worldwide were living with a disabling hearing difficulties. During the World Health Assembly in 2017, with the adoption of the resolution WHA70.13, hearing care and hearing loss were highlighted as a public health issue. Authors claim that most of the causes for hearing loss are preventable. World Hearing Day is an international campaign, organized annually by the Office of Prevention of Blindness and Deafness of the World Health Organization (WHO) on March, 3rd. Organizers claim that World Hearing Day is the largest global awareness event, aiming to bring society’s attention to ear and hearing disorders. It addresses hearing loss. First activities, connected with the World Hearing Day, took place in 2007, after the Beijing Declaration during the 1st International Conference on Prevention and Rehabilitation of Hearing Loss. Conclusions Legislative measures are need to be undertaken to stress even further the importance of proper hearing. In the era of COVID-19 pandemic and its proven consequences on the hearing and vestibular system, urgent measures for timely diagnostics, treatment and rehabilitation are more than ever needed.

Роль санаторно-курортного лечения в системе комплексной слухоречевой реабилитации лиц с нейросенсорной формой тугоухости

The article presents statistical data reflecting the prevalence of various types of hearing loss, the dynamics of frequency changes of the sensorineural type, as the most common, in the structure of hearing loss. Literature data are presented confirming the relevance of further comprehensive study of the issues of treatment and rehabilitation of hearing loss, including the use of physical and natural factors. The article reflects the data characterizing the high efficiency of health resort treatment of people with sensorineural hearing loss with the right choice of resort and compliance with the indications. The main types of health resort treatment recommended for patients with sensorineural hearing loss are listed. It has been shown that the use of these techniques in complex therapy optimizes the rehabilitation prognosis and improves the quality of life of people with sensorineural hearing loss.

What does microbiology have to do with the Hearing for Learning Initiative (HfLI)?

Where would we be without microbiology in tackling the high prevalence of otitis media (OM; middle ear infection) and disabling hearing loss that disadvantage Australian First Nations children living in remote communities? Understanding the microbiology of OM in this population has been critical in directing innovative clinical trials research and developing appropriate evidence-based practice guidelines. While these processes are critical to reducing disadvantage associated with OM and disabling hearing loss, a remaining seemingly insurmountable gap has remained, threatening progress in improving the lives of children with ear and hearing problems. That gap is created by the crisis in primary health care workforce in remote communities. Short stay health professionals and fly-in fly-out specialist services are under-resourced to manage the complex needs of the community, including prevention and treatment of otitis media and hearing loss rehabilitation. Hence the rationale for the Hearing for Learning Initiative – a workforce enhancement model to improve sustainability, cultural appropriateness, and effectiveness of evidence-based ear and hearing health care for young children in remote settings. This paper summarises the role of microbiology in the pathway to the Hearing for Learning Initiative.

Factors Influencing Hearing Aid Satisfaction in South Korea.

PurposeThe purpose of this study is three-fold: 1) to evaluate factors influencing hearing aid (HA) satisfaction; 2) to provide a profile of HA satisfaction in daily life; and 3) to examine the reasons why people gave up using HAs.Materials and MethodsData for 1148 respondents were statistically analyzed and reported.ResultsIn the study, age (β=-0.03, p<0.01), level of education (β=1.21, p<0.01), HA purchase price (β=1.50, p<0.01), bilateral amplification (β=1.23, p<0.01), wearing time (β=0.28, p<0.01), and HA fitting and fine tuning on a regular basis (β=1.71, p<0.01) significantly influenced HA satisfaction. In addition, the authors observed that the most satisfactory factors were clarity of sound (53.5%), people’s trust in their HA (61.7%), and listening from a quiet environment (72.8%) in the domains of sound quality, HA features, and listening environments, respectively. Finally, with multiple choices being possible, 65% of the 40 respondents who no longer used HAs answered that their HAs ended up in a drawer since the background noise was annoying and distracting.ConclusionThis study is significant in that it is a large-scale multi-center research to comprehensively examine the factors influencing HA satisfaction in South Korea. This data will provide helpful information that could lead to the successful rehabilitation of hearing loss with HAs.

聴覚障害のリハビリテーション医学・医療

聴覚障害のリハビリテーション医学・医療

Effect of Reading Rehabilitation for Age-Related Macular Degeneration on Cognitive Functioning: Protocol for a Nonrandomized Pre-Post Intervention Study.

BackgroundAge-related vision impairments and dementia both become more prevalent with increasing age. Research into the mechanisms of these conditions has proposed that some of their causes (eg, macular degeneration/glaucoma and Alzheimer’s disease) could be symptoms of an underlying common cause. Research into sensory-cognitive aging has provided data that sensory decline may be linked to the progression of dementia through reduced sensory stimulation. While hearing loss rehabilitation may have a beneficial effect on cognitive functioning, there are no data available on whether low vision rehabilitation, specifically for reading, could have a beneficial effect on cognitive health.ObjectiveThe research questions are: (1) Does low vision rehabilitation reduce reading effort? (2) If so, does reduced reading effort increase reading activity, and (3) If so, does increased reading activity improve cognitive functioning? The primary objective is to evaluate cognition before, as well as at 6 months and 12 months after, 3 weeks of low vision reading rehabilitation using magnification in individuals with age-related macular degeneration, with or without coexisting hearing impairments. We hypothesize that improvements postrehab will be observed at 6 months and maintained at 12 months for participants with vision loss and less so for those with dual sensory loss. The secondary objective is to correlate participant characteristics with all cognitive outcomes to identify which may play an important role in reading rehabilitation.MethodsWe employ a quasiexperimental approach (nonrandomized, pre-post intervention study). A 3x3 design (3 groups x 3 time points) allows us to examine whether cognitive performance will change before and after 6 months and 12 months of a low vision reading intervention, when comparing 75 low vision and 75 dual sensory impaired (vision & hearing) participants to 75 age-matched healthy controls. The study includes outcome measures of vision (eg, reading acuity and speed), cognition (eg, short-term and long-term memory, processing speed), participant descriptors, demographics, and clinical data (eg, speech perception in noise, mental health).ResultsThe study has received approval, and recruitment began on April 24, 2019. As of March 4, 2021, 38 low vision and 7 control participants have been enrolled. Lockdown forced a pause in recruitment, which will recommence once the COVID-19 crisis has reached a point where face-to-face data collection with older adults becomes feasible again.ConclusionsEvidence of protective effects caused by reading rehabilitation will have a considerable impact on the vision rehabilitation community and their clients as well as all professionals involved in the care of older adults with or without dementia. If we demonstrate that reading rehabilitation has a beneficial effect on cognition, the demand for rehabilitation services will increase, potentially preventing cognitive decline across groups of older adults at risk of developing macular degeneration.Trial RegistrationClinicalTrials.gov NCT04276610; Unique Protocol ID: CRIR-1284-1217; https://clinicaltrials.gov/ct2/show/NCT04276610International Registered Report Identifier (IRRID)DERR1-10.2196/19931

Hearing and dementia: is there a link?

The review of literature considers the correlation between hearing loss and dementia. Hearing loss is one of the few potentially modifiable factors in terms of dementia prevention, and the research highlighted in this article confirms the need to continue studying this correlation to better understand the benefits of treating hearing loss in order to improve cognitive function. It should be kept in mind that hearing loss also has social consequences in the form of reduced daily activity, communication function, isolation, loss of independence, impaired ability to drive vehicles, and this once again confirms the importance of timely treatment of hearing loss. This article also addresses the problem of late diagnosis, lack of treatment and rehabilitation of hearing loss in elderly people.

Speech Perception With Novel Stimulation Strategies for CombinedCochleo-Vestibular Systems.

Cochlear implants are very well established in the rehabilitation of hearing loss and are regarded as the most successful neuroprostheses to date. While a lot of progress has also been made in the neighboring field of specific vestibular implants, some diseases affect the entire inner ear, leading to both hearing and vestibular hypo- or dysfunction. The proximity of the cochlear and vestibular organs suggests a single combined implant as a means to alleviate the associated impairments. While both organs can be stimulated in a similar way with electric pulses applied through implanted electrodes, the typical phase durations needed in the vestibular system seem to be substantially larger than those typically needed in the cochlear system. Therefore, when using sequential stimulation in a combined implant, the pulse stream to the cochlea is interrupted by comparatively large gaps in which vestibular stimulation can occur. We investigate the impact of these gaps in the auditory stream on speech perception. Specifically, we compare a number of stimulation strategies with different gap lengths and distributions and evaluate whether it is feasible to use them without having a noticeable decline in perception and quality of speech. This is a prerequisite for any practicable stimulation strategy of a combined system and can be investigated even in recipients of a normal cochlear implant. Our results show that there is no significant deterioration in speech perception for the different strategies examined in this paper, leaving the strategies as viable candidates for prospective combined cochleo-vestibular implants.

Tendoplasty and its effectiveness in the rehabilitation of hearing loss in patients with otosclerosis

The article briefly presents the physiology of the stapes muscle tendon (SMT), and features in its defeat. Its length was studied using high-resolution multispiral computed tomography of the temporal bones. We also studied the possibility of its restoration using the author's method of tendoplasty using metallized stapes prostheses. Tendoplasty with stapedoplasty was performed in 74 patients with otosclerosis (OS), and 48 patients had stapedoplasty without tendoplasty. As a result of research, the average length of the SMT was 2.38±0.02 mm, which explains the need to use a 3 mm long venous autograft for tendoplasty. The author's method of tendoplasty for stapedoplasty allows restoring the acoustic reflex in 54.1% of OS patients using artificial stapes prostheses. The preservation of the vascular bed in the thickness of the restored tendon can improve the trophy of the long incus process and reduce the risk of its dystrophic changes in the postoperative period. In addition, this fact confirms the importance of the stapes muscle in the acoustic reflex.

Factors Influencing Hearing Disability and Reduction in Disability among First-time Hearing Aid Users in Singapore

This study aims to examine the factors associated with self-reported hearing disability and early reduction in disability after first-time hearing aid (HA) fitting in Singapore. Retrospective record review of 1,068 subjects issued with HAs at a tertiary hospital from 2001 to 2013. Subjects reporting ≥5 disabilities reduced from 90% to 24% after HA fitting. 'Difficulty hearing in noise' was the commonest disability before and after HA fitting, while 'needs to increase volume of TV/radio' was the disability with most improvement after fitting. In multivariable models, having worse pure tone audiometry (PTA) thresholds of the better hearing ear and being ethnically Chinese were associated with subjects reporting more hearing disabilities. A higher proportion of subjects reported a reduction rather than an absence of disability after HA fitting. In multivariable models, daily HA usage for ≥4 hours, sensorineural hearing loss (HL) and worse PTA thresholds of the better hearing ear were associated with reduction in more disabilities after HA fitting. Hearing disability is high among first-time HA users in Singapore. Ethnicity and PTA thresholds were associated with self-reported hearing disability. After HA fitting, higher daily HA usage, sensorineural HL, and worse PTA thresholds of the better hearing ear were associated with early reduction in disability. Patient counselling on the benefits of HL rehabilitation could focus on hearing disability rather than PTA thresholds. The management of patients' expectations could focus on reducing rather than eliminating disability.