Significant Hearing Loss Research Articles

Screening for Developmental Delays in Pediatric Cochlea Implant Candidates and Recipients.

Conduct a pilot clinical improvement project to effectively screen children with hearing loss for developmental delays. Children with hearing loss and cochlear implants (CIs) are at risk for additional developmental delays; however, screening to aid in early identification and referral for developmental delays is not routinely performed at CI centers. It is important to consider all aspects of child development to maximize CI outcomes and access to language. Caregivers of 31 children completed the Ages and Stages Questionnaire (ASQ) and the Sensory Profile-2 (SP2), which are standardized questionnaires that assess developmental milestones in areas of communication, gross motor, fine motor, problem solving, personal-social, and sensory integration. Participants were prospectively evaluated at a CI center in a tertiary medical center. Participants included children, aged ≤5 years old with bilateral hearing loss who use CIs or who were CI candidates, and their families. Scores on ASQ and SP2 questionnaires. Thirty-one children were screened, and approximately 40 to 50% screened positive for risk of developmental delay in areas excluding communication and received referrals for evaluations in occupational therapy (n = 16; 51.6%), physical therapy (n = 13; 41.9%), and developmental pediatrics (n = 13; 41.9%). Of children referred and seen for evaluations, six were diagnosed with developmental delays in at least one developmental area beyond the communication domains. Routine screening in children with significant hearing loss can successfully detect developmental delays, which may go unnoticed. This proactive approach enables timely and comprehensive treatment for developmental delays beyond those solely related to communication.

Ototoxicity associated with hematopoietic stem cell transplantation; what are the risk factors?

Background Hematopoietic stem cell transplantation (HSCT) is a critical treatment for various hematologic malignancies but can lead to complications, including ototoxicity. Aim/objectives This study aims to explore the relationship between patient-specific factors and ototoxicity in adult HSCT patients. Material and Methods We conducted a retrospective analysis of 129 adult patients who underwent HSCT between 2003 and 2020. Age, gender, transplant indications, conditioning regimens, and pre- and post-transplant audiometry thresholds data were collected from patient files. A hearing loss of 10 decibels or more at two consecutive frequencies or a hearing loss of 20 decibels or more at a single frequency was considered as significant hearing loss (SHL). Statistical analyses were performed to describe factors associated with SHL. Results SHL occurred in 16.3% of patients. Older age was significantly associated with an increased risk of SHL (p = .035). Poorer pretransplant hearing thresholds at 4000 Hz and 6000 Hz were also significant predictors of SHL (p = .039 and p = .014, respectively). There was no significant relationship between the donor type of HSCT (autologous vs. allogeneic) and ototoxicity (p = .45), and between conditioning regimens and ototoxicity (p = .860). Conclusions Age and pre-existing hearing levels are significant predictors of ototoxicity post-HSCT. Careful management and monitoring are essential to prevent and address hearing loss in HSCT patients to improve hearing-related quality of life.

Outcomes in Pediatric Cholesteatoma.

The objective of the study is to evaluate the outcomes of surgical management options for cholesteatoma using a national database. Database analysis of the Pediatric Health Information System database to identify children undergoing surgical intervention for cholesteatoma from October 2015 to December 2022. Patients were categorized by initial surgical modality: tympanoplasty (TM), tympanoplasty with canal wall-up tympanomastoidectomy (TM-CWU), and tympanoplasty with canal wall-down tympanomastoidectomy (TM-CWD). Group comparisons were done on number of surgical revisions and number of patients identified with recommendations for hearing aids. A total of 6304 patients were identified in the database who underwent surgery for cholesteatoma. Of these children, 3405 underwent TM (54.0%), 3116 underwent TM-CWU (49.4%), and 825 underwent TM-CWD (8.2%). The estimated difference in mean number of procedures was significantly higher in the TM-CWU group compared to TM-CWD (-0.34, 95% confidence interval [CI] -0.406,-0.279, P < .0001) and the TM group (9.352, 95% CI 0.315, 0.390, P < .0001). The rate of significant hearing loss necessitating hearing aids was significantly lower in the TM group, but there was no difference between the TM-CWU and TM-CWD groups (1.2%, P < .03, 1.9% vs 2.7%, P = .13). There was no difference in the number of speech delays/therapy diagnoses between TM and TM-CWU or TM-CWU and TM-CWD (3.5%vs 4.4% P = .07, 4.4% vs 5.2%., P = .38). TM and TM-CWD had lower total surgical procedures than the TM-CWU group, and the TM group had a lesser rate of recommendation for hearing aids. The difference between number of procedures is likely due to the complexity of the disease; for instance, TM was likely chosen for small, less severe disease cases, whereas TM-CWD was chosen as more definitive treatment in aggressive cases. TM-CWD is associated with a lower rate of recidivism and recurrence, which also likely contributed to the lower number of procedures.

Diagnosis of auditory disorders in dental patients with altered occlusal relationships (Part 1)

Relevance. Recently, dental patients have been increasingly presenting with not only aesthetic, functional, and painrelated concerns, but also various otological symptoms, such as ear congestion, discomfort, and perceived hearing loss. These symptoms may be linked to underlying dental conditions, especially those involving a reduction in interalveolar distance (IAD), and must be carefully differentiated from ENT disorders and true hearing impairment.Objective: To evaluate the auditory function in dental patients with partial tooth loss and complaints of pathological otological symptoms.Materials and methods. The study included 357 dental patients aged 43 to 72 years, comprising 287 women (80.4%) and 70 men (19.6%) with partial tooth loss. The examination involved a functional-physiological method for determining the central relationship of the jaws using the Apparatus for Determining Central Occlusion (AOTSO) and tonal threshold audiometry.Results. A reduction in interalveolar height of varying degrees was confirmed in 325 (91%) patients with dental arch defects, while no decrease was observed in 23 (9%) patients. All patients with otological complaints exhibited a reduction in lower facial height. Of the 87 patients with otological complaints, 37 (42.5%) were diagnosed with significant hearing loss based on tonal threshold audiometry.Conclusion. The examination of this group of dental patients with dental arch defects, utilizing modern diagnostic methods, confirmed a reduction in interalveolar distance. Additionally, otological complaints were identified, and pathological auditory conditions, such as various forms of hearing loss, were verified through tonal threshold audiometry.

Impedance and Functional Outcomes in Robotic-Assisted or Manual Cochlear Implantation: A Comparative Study

Introduction: Preservation of residual hearing, mainly the low frequencies, is the current main objective of cochlear implantation. New electrode arrays and the development of minimally invasive surgery have allowed electroacoustic stimulation. Over the past several years, robotic-assisted cochlear implant surgery aimed to improve the insertion process while respecting inner ear structures. However, the introduction of a foreign body inside the cochlea can lead to the development of fibrous tissue around the electrode array, or even induce osteogenesis. These histological changes disrupt the parameters of the cochlear implant, resulting in elevated impedance. In addition, long-term auditory performance can be affected, with a deterioration in word comprehension. We evaluated the potential impact of RobOtol® on impedance changes over time, leading to potentially positive functional outcomes. Methods: Cochlear implant surgery with a round window approach was performed under general anesthesia. Fifteen Med-El Flex24 electrode arrays were inserted manually and 24 using RobOtol®. All subjects underwent pure-tone audiometry tests before the surgery and at regular intervals up to 1 year after the surgery. Based on the pure-tone average at the low frequencies from 250 to 1,000 Hz, we divided the patients according to the degree of auditory preservation (full preservation ≤15 dB, partial preservation 15 dB–30 dB, significant loss >30 dB). These different groups were compared in terms of impedance changes and auditory performance, specifically word recognition score. Results: We found proportionally fewer patients who experienced significant low-frequency hearing loss after robotic insertion (53.33% in the manual group compared to 41.67% in the robot-assisted insertion group). Impedance changes at the apex of the electrode array, especially at the first electrode (p = 0.04), after robotic surgery, with less overall variability, a continuous decreasing trend without secondary elevation, and lower values in cases of complete residual hearing preservation (for the three first electrodes: p = 0.017, p = 0.04, p = 0.045). The speech intelligibility amelioration over time showed favorable evolution in patients with complete residual hearing preservation regardless of the insertion method. However, in the absence of auditory preservation, the positive evolution continued more than 6 months after robotic surgery but stagnated after manual insertion (difference at 1 year, p = 0.038; median auditory capacity index 83% vs. 57%). Conclusion: Atraumatic electrode array insertion with consistent, slow speed and the assistance of RobOtol® minimizes disturbances in the delicate neurosensory structures of the inner ear and leads to better auditory performance.

Extended High-frequency Audiometry in the Elderly: A Narrative Review.

Extended high-frequency audiometry (HFA) is considered an important tool in the detection of hearing loss. However, the values at extended high frequencies (EHF) in older adults (in both men and women) are associated with considerable uncertainty due to limited reference data. The presented review aimed to analyze hearing thresholds at EHF in adults older than 60 years. A literature search for HFA-related keyword combinations was conducted using the electronic databases PubMed, Scopus, and Web of Science. A total of 1654 records, published in the last 22 years, were identified through this search, of which only 7 articles were ultimately included in the analysis. Multiple studies have shown that significant hearing loss can be observed at EHF in older adults. Hearing thresholds in the frequency range of 9-20 kHz in the elderly varied widely across the studies. Therefore, further research in this field is needed to complete the normative data.

Occupational noise-induced hearing loss among dental personnel: a scoping review.

Introduction Dental personnel are being exposed to noisy equipment on a daily basis and there are indications that dental professionals are at a higher risk of developing occupational noise-induced hearing loss (NIHL). Therefore, this study aims to assess the available research on NIHL among dental professionals.Methods A total of 452 publications were identified through searches on PubMed and Web of Science. These studies were screened on title and abstract for studies that investigated NIHL among dental professionals using objective or subjective parameters for hearing loss. The remaining publications were then searched for relevant data, such as research type, parameters used for measuring hearing loss and authors' conclusions.Results In total, 28 publications were finally included in the selection. Of this selection, 23 used objective criteria for NIHL, three used subjective criteria and two used both. From the 12 studies with objective measurements that also included a control group in their studies, eight reported a significant higher hearing loss among dental personnel than in the control groups. From the 13 studies with objective measurement without a control group, seven reported significant hearing loss among dental personnel. All five studies with subjective measurements reported significant hearing loss in dental personnel.Conclusions Hearing loss seems to be more prevalent among dental personnel than in most control groups.

Application of Machine Learning Algorithms to Analyze the Clinical Characteristics of NIHL Caused by Impulse Noise and Steady Noise.

Occupational hearing loss of workers exposed to impulse noise and workers exposed to steady noise for a long time may have different clinical characteristics. As of May 2019, all 92 servicemen working in a weapon experimental field exposed to impulse noise for over 1 year were collected as the impulse noise group. As of Dec 2019, all 78 servicemen working in an engine working experimental field exposed to steady noise for over 1 year were collected as the steady noise group. The propensity score matching (PSM) model was used to eliminate the imbalance of age and working time between the two groups of subjects. After propensity score matching, 51 subjects in each group were finally included in the study. The machine learning model is constructed according to pure tone auditory threshold, and the performance of the machine learning model is evaluated by accuracy, sensitivity, specificity, and AUC. Subjects in the impulse noise group and the steady noise group had significant hearing loss at high frequencies. The hearing of the steady noise group was worse than that of the impulse noise group at speech frequency especially at the frequency of 1 kHz. Among machine learning models, XGBoost has the best prediction and classification performance. The pure tone auditory threshold of subjects in both groups decreased and at high frequency. The hearing of the steady noise group at 1 kHz was significantly worse than that of the impulse noise group. XGBoost is the best model to predict the classification of our two groups. Our research can guide the prevention of damage caused by different types of noises.

Detecting Hearing Loss Through Targeted Surveillance: Risk Registry and Surveillance Timeframe Recommendations.

The purpose of this study was to inform the revision of a targeted surveillance risk registry by identifying which risk factors predict postnatally identified hearing loss (PNIHL) in children who pass newborn hearing screening and to determine whether hearing surveillance beyond the age of 1 year is warranted. We used retrospective analysis of the audiological outcomes of children born in the state of Queensland, Australia, between January 1, 2010, and December 31, 2019, who passed the newborn hearing screen with risk factors. Approximately one third of children were lost to follow-up and could not be included in the analysis. Risk factors that predicted PNIHL in the analyzed cohort were as follows: syndromes associated with hearing loss, craniofacial anomalies, perinatal infections, and family history of permanent childhood hearing loss. Severe asphyxia did not predict PNIHL but yielded some cases of significant bilateral hearing loss. Hearing loss in children with a history of prolonged ventilation was mild and/or unilateral in nature (except in cases where the hearing loss was due to an unrelated etiology). There were no cases of PNIHL in children with hyperbilirubinemia or neonatal bacterial meningitis. For the risk factors that predicted PNIHL, nearly all hearing losses were detected by 1 year of age, except for children with family history where one quarter of hearing losses had a later onset. The four risk factors recommended for efficient postnatal identification of hearing loss are as follows: syndromes associated with hearing loss, craniofacial anomalies, perinatal infection, and family history of permanent childhood hearing loss. Hearing surveillance through to 1 year old is sufficient except for children with a family history, where a second phase assessment is indicated. Alternative targeted surveillance protocols and models of care are required to minimize loss to follow-up.

OUR EXPERIENCE IN SURGICAL TREATMENT OF MUCOSAL HYPERTROPHY OF TORI TUBARII

Puprose. Evaluation of the effectiveness of surgical treatment of mucous hypertrophy of tori tubarii by submucosal tissue destruction using Ho:YAG laser radiation. Materials and methods. The study involved 48 adult patients with symptoms of Eustachian tube dysfunction. The patency of the auditory tube was assessed by standard tests, the ETDQ 7 questionnaire, tympanometry, pure tone threshold audiometry, and endoscopic video recording of the results were performed. Surgical intervention was carried out by forming under the influence of pulsed radiation from a Ho:YAG laser with a frequency of 10 Hz and a pulse energy of 2 J, 4–6 tunnels with a depth of 5–7 mm in the hypertrophied mucous membrane of the torui tubarii along the posteromedial surface and 2 tunnels up to 3 mm up and down from the pharyngeal mouth of the auditory tube. The control periods after surgery were 1, 3 and 6 months. Results. A significant improvement in the results of the auditory tube according to ETDQ-7 was noted by 3 months after surgery in 71% of patients and in 84% by 6 months. By 6 months after surgery, type C tympanometry and clinically significant conductive hearing loss persisted in 8 and 5% of patients, respectively. The subjective feeling of fully performing the Valsalva test improved in 58% after 3 months and in 82% by the 6th month, and the Toynbee test in 42% and 64% in the 3rd and 6th months, respectively. In 16% of patients, despite a visual decrease in mucosal hypertrophy during endoscopic examination, signs of dysfunction remained according to ETDQ 7. There were no complications after surgical treatment during 6 months of observation. Conclusion. The use of endoscopic diagnosis of the nasopharynx in patients with signs of dysfunction of the auditory tubes in combination with functional tests and the ETDQ-7 questionnaire allows to determine the indications for the surgical treatment of hypertrophy of the mucous membrane of the tori tubarii using the Ho:YAG laser, the effectiveness of which in our study was 84%.

Early Loss of Spiral Ganglion Neurons in the Auditory System after Noise Trauma

Introduction: Noise-induced hearing loss is one of the most frequent recognized occupational diseases. The time course of the involved pathologies is still under investigation. Several studies have demonstrated an acute damage of the sensory tissue, but only few experiments investigated the degeneration of (type I) spiral ganglion neurons (SGNs), representing the primary neurons in the auditory system. The aim of the present study was to investigate the time course of SGN degeneration within a 7-day period after traumatic noise exposure starting immediately after trauma. Methods: Young adult normal hearing mice were noise exposed for 3 h with a broadband noise (5–20 kHz) at 115 dB SPL. Auditory threshold shift was measured by auditory brainstem recordings, and SGN densities were analyzed at different time points during the first week after acoustic trauma. Results: Significant reduction of SGN densities was detected and is accompanied by a significant hearing loss. Degeneration starts within hours after the applied trauma, further progressing within days post-exposure. Discussion: Early neurodegeneration in the auditory periphery seems to be induced by direct overstimulation of the auditory nerve fibers. SGN loss is supposed to be a result of inflammatory responses and neural deprivation, leading to permanent hearing loss and auditory processing deficits.

Clinical Practice Guideline: Age-Related Hearing Loss.

Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantationcandidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life (QOL). (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related QOL at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.

Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary.

Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with an explanation of the support in the literature, the evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the Guideline Development Group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life. (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related quality of life at a subsequent health care encounter or within 1 year. The GDG offered the following KASas an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.

Hearing Outcomes from Gamma Knife Treatment for Intracanalicular Vestibular Schwannomas with Good Initial Hearing.

Background: The objective of this study was to describe the long-term hearing outcomes of gamma knife treatment for unilateral progressing vestibular schwannomas (VS) presenting with good initial hearing using audiologic data. Methods: A retrospective review was performed between 2010 and 2020 to select patients with progressing unilateral VS and good hearing (AAO-HNS class A) treated with stereotactic gamma knife surgery (GKS). Their audiograms were analyzed along with treatment metrics and patient data. Results: Hearing outcomes with a median follow-up of 5 years post-treatment showed statistically significant loss of serviceable hearing: 34.1% of patients maintained good hearing (AAO-HNS class A), and 56.1% maintained serviceable hearing (AAO-HNS class A and B). Non-hearing outcomes are favorable with excellent tumor control and low facial nerve morbidity. Conclusions: Hearing declines over time in intracanalicular VS treated with GKS, with a significant loss of serviceable hearing after 5 years. The mean cochlear dose and the presence of cochlear aperture obliteration by the tumor are the main statistically significant factors involved in the hearing outcomes.

Hearing Recovery Prediction for Patients with Chronic Otitis Media Who Underwent Canal-Wall-Down Mastoidectomy.

Background: Chronic otitis media affects approximately 2% of the global population, causing significant hearing loss and diminishing the quality of life. However, there is a lack of studies focusing on outcome prediction for otitis media patients undergoing canal-wall-down mastoidectomy. Methods: This study proposes a recovery prediction model for chronic otitis media patients undergoing canal-wall-down mastoidectomy, utilizing data from 298 patients treated at Korea University Ansan Hospital between March 2007 and August 2020. Various machine learning techniques, including logistic regression, decision tree, random forest, support vector machine (SVM), extreme gradient boosting (XGBoost), and light gradient boosting machine (light GBM), were employed. Results: The light GBM model achieved a predictive value (PPV) of 0.6945, the decision tree algorithm showed a sensitivity of 0.7574 and an F1 score of 0.6751, and the light GBM algorithm demonstrated the highest AUC-ROC values of 0.7749 for each model. XGBoost had the most efficient PR-AUC curve, with a value of 0.7196. Conclusions: This study presents the first predictive model for chronic otitis media patients undergoing canal-wall-down mastoidectomy. The findings underscore the potential of machine learning techniques in predicting hearing recovery outcomes in this population, offering valuable insights for personalized treatment strategies and improving patient care.

Effect of subsequent context on the real-time interpretation of ambiguous target words in spectrally degraded speech

Subsequent context in a sentence can be used to revise the interpretation of a word that was not clearly heard, a frequent occurrence in degraded speech. One strategy for avoiding the cognitive cost associated with revising an initial interpretation is to delay commitment to an interpretation until the end of the sentence, sometimes called a “wait-and-see” strategy. Listening with a significant hearing loss (i.e., constantly hearing degraded speech), may prompt a listener to use this strategy even in relatively easy listening conditions. This study used an eye-tracker to record gaze patterns during a phoneme classification task of ambiguous target words in two levels of background noise ( + 5 and −5 dB SNR). Participants either used cochlear implants (CIs) or were presented 8-channel noise vocoded speech. The target words were at the beginning of sentences; the subsequent context cued one target word interpretation (based on phoneme classification) or the other. We hypothesized that listeners who use CIs will demonstrate a delaying strategy at both levels of background noise, while listeners who have acoustic hearing will only demonstrate a delaying strategy at the highest level of background noise. These findings have implications for rehabilitative strategies to improve communication outcomes in adults with CIs.

Risk of hearing loss in non-operated ear due to mastoid drilling

Background: The study purpose is to evaluate the effect of drill-generated high intensity noise on hearing sensitivity in contralateral ear. Methods: Sixty patients who underwent mastoidectomy were studied to see the effect of mastoid drilling on hearing sensitivity in normal ear using pure tone audiometry (PTA) and distortion product otoacoustic emission (OAE) values recorded preoperatively and postoperatively. Results: For PTA, there is no significant hearing loss for 0.25 kHz and 0.50 kHz for all PODs. For 1 kHz, 2 kHz and average PTA there is significant temporary hearing loss from POD 1 to POD 7 which normalizes around POD 30. However, there is significant temporary threshold shift for 4 kHz and 8 kHz from POD 1 to POD 5 and the hearing sensitivity improves to preoperative levels at POD 7. For OAE, 1 kHz, 4 kHz and average OAE there is significant temporary hearing loss from POD 1 to POD 7 which normalizes around POD 30. However, there is significant temporary threshold shift for 2 kHz and 6 kHz from POD 1 to POD 5 and hearing sensitivity improves to preoperative levels at POD 7. There is a significant correlation between drilling duration and PTA averages and OAE averages. Conclusions: Sensorineural hearing loss is more prevalent following modified radical and radical mastoidectomy as compared to canal wall up mastoidectomy. The factors influencing postoperative contralateral ear sensorineural hearing loss are type and size of burr and the duration of burr use.

Single-Sided Deafness and Hearing Rehabilitation Modalities: Contralateral Routing of Signal Devices, Bone Conduction Devices, and Cochlear Implants.

Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes.

Audiologists' attitudes and practice toward referring for psychosocial intervention with cochlear implant patients.

Hearing loss is associated with a range of poor psychosocial outcomes. Cochlear implants (CI) are an available treatment option for significant hearing loss and have been linked to improved quality of life in patients. Evidence suggests that audiologists lack the skills to appropriately detect, address, and refer for psychosocial needs among patients with hearing loss. The objective of this study is to examine the attitudes and practice patterns related to psychosocial care among audiologists who work with CI users. A cross-sectional survey was administered to clinical audiologists who work with CI recipients in the United States. The survey evaluated participants' attitudes toward psychosocial services and factors that contribute to their abilities to address the psychosocial needs of their patients. Additionally, participants were surveyed about their practice patterns including the use of psychosocial screeners, clinical protocols regarding psychosocial care, and referral patterns for coordinated psychosocial services. Descriptive statistics were used to summarize survey responses. Sixty-eight audiologists completed the survey. Of these audiologists, a majority (73.6%) held the attitude that most or all CI patients would benefit from psychosocial intervention. Despite clinicians' recognition of psychosocial needs in this population, over 90% of participants reported never screening for psychosocial symptoms. Additionally, a majority of respondents indicated that they seldom refer their patients for psychosocial services, with referrals occurring less than half the time (58%) or never (27%). Additionally, few audiologists reported utilizing protocols or resources for guiding psychosocial practices. Audiologists indicated that the primary factors that influence their psychosocial practices include time available to spend with the patient and their comfort level in counseling. Audiologists working with CI patients recognize the potential benefit of psychosocial intervention in this population. Nevertheless, audiologists encounter barriers in clinical practice which limit their ability to identify and address the psychosocial needs of their patients. Strategies designed to enhance audiologists' capacity to recognize the psychosocial needs of CI users, in addition to improved interprofessional practice on CI teams, implies significant opportunities to improve the provision of patient-centered hearing care.

Heightened OAEs in young adult musicians: Influence of current noise exposure and training recency

Otoacoustic emissions (OAEs) are a non-invasive metric of cochlear function. Studies of OAEs in musicians have yielded mixed results, ranging from evidence of diminished OAEs in musicians—suggesting noise-induced hearing loss—to no difference when compared to non-musicians, or even a trend for stronger OAEs in musicians. The goal of this study was to use a large sample of college students with normal hearing (n = 160) to compare OAE SNRs in musicians and non-musicians and to explore potential effects of training recency and noise exposure on OAEs in these cohorts. The musician cohort included both active musicians (who at the time of enrollment practiced at least weekly) and past musicians (who had at least 6 years of training). All participants completed a questionnaire about recent noise exposure (previous 12 months), and a subset of participants (71 musicians and 15 non-musicians) wore a personal noise dosimeter for one week to obtain a more nuanced and objective measure of exposure to assess how different exposure levels may affect OAEs before the emergence of a clinically significant hearing loss. OAEs were tested using both transient-evoked OAEs (TEOAEs) and distortion-product OAEs (DPOAEs). As predicted from the literature, musicians experienced significantly higher noise levels than non-musicians based on both subjective (self-reported) and objective measures. Yet we found stronger TEOAEs and DPOAEs in musicians compared to non-musicians in the ∼1–5 kHz range. Comparisons between past and active musicians suggest that enhanced cochlear function in young adult musicians does not require active, ongoing musical practice. Although there were no significant relations between OAEs and noise exposure as measured by dosimetry or questionnaire, active musicians had weaker DPOAEs than past musicians when the entire DPOAE frequency range was considered (up to ∼16 kHz), consistent with a subclinical noise-induced hearing loss that only becomes apparent when active musicians are contrasted with a cohort of individuals with comparable training but without the ongoing risks of noise exposure. Our findings suggest, therefore, that separate norms should be developed for musicians for earlier detection of incipient hearing loss. Potential explanations for enhanced cochlear function in musicians include pre-existing (inborn or demographic) differences, training-related enhancements of cochlear function (e.g., upregulation of prestin, stronger efferent feedback mechanisms), or a combination thereof. Further studies are needed to determine if OAE enhancements offer musicians protection against damage caused by noise exposure.