Background: In busy clinics, audiologists can benefit from brief, patient-centered tools to identify those with hearing difficulties. Pure-tone and speech audiometry measures, as well as self-report measures, require time and significant patient engagement. Visual analog scales have been used in health care as an accessible and simple way to understand patients’ multifaceted experiences. Purpose: To develop and test a brief, facial-based visual instrument, the Facial Scale for Hearing Difficulty (FSHD), that could provide a clinically useful complement to traditional diagnostic testing. Research Design: Correlational. Study Sample: Twenty-three adults with hearing profiles ranging from normal hearing (defined as −10 to <25 dB HL) to profound hearing loss. Intervention: The FSHD is a single-item, face-based visual analog scale that features five expressive faces ranging from 1 (no difficulty) to 5 (extreme difficulty). Data Collection and Analysis: Participants were asked to select the face from the FSHD that best represents their difficulty hearing. Participants also completed pure-tone audiometry, the Quick Speech-in-Noise test (QuickSIN), and a hearing handicap measure. Results: The FSHD had very strong, positive correlations with hearing handicap scores (ρ = 0.803, p < 0.001), pure-tone averages (ρ = 0.753, p < 0.001 for the better ear; ρ = 0.635, p = 0.001 for the worse ear), and QuickSIN (ρ = 0.567, p = 0.005). Conclusions: The FSHD is a quick instrument that can be administered in less than 1 minute and provides insight into patient difficulties with hearing. Given the strong associations with established clinical measures, the scale could be used as a point-of-entry tool for patient-centered care. Clinical Relevance Statement: The FSHD can help support clinical decision-making by helping to quickly identify patients who could benefit from further assessment, counseling, or aural rehabilitation. Because the instrument does not rely on technical language, literacy, or lengthy questionnaires, it could be well suited for inclusive service delivery in private or public practice, across diverse populations, or in under-resourced or fast-paced clinical settings.

ABSTRACTObjectives:To evaluate the simplified version of the Arabic matrix test in individuals with normal hearing to derive reference ranges for future measurements with the test material.MethodsThe test was conducted in 80 native Arabic individuals (20 adults and 60 children across different age groups between 5-10 years) from November 2020 to Mar 2023. Evaluation measurements were conducted in adults and children to derive the reference psychometric functions and assess the training effect. The test list equivalence was verified only in the adults group.ResultsThe reference ranges for speech-intelligibility in noise for 80% thresholds or speech-recognition threshold (SRT80) were as follows: -0.8 ± 2.4 dB signal-to-noise ratio (SNR) (Group 1; 5-6 years), -2.4 ± 2.5 dB SNR (Group 2; 7-8 years) and -2.9 ± 2.3 dB SNR (Group 3; 9-10 years).ConclusionThe study demonstrated an influence of age on the measured word recognition performance in children, highlighting the test’s suitability for this population. The reliability of the test was 1.1 dB for 80% threshold and 1.4 dB for 50% threshold. With promising results, this test can be used as a new tool in speech audiometry in audiological diagnostics and management with special focus on modern standard Arabic for children.

Cochlear implantation in the very elderly: Longitudinal assessment of device use and outcomes.

BackgroundThe association between hearing loss and cognitive impairment has become a focus of public health research. This study aims to explore the correlations between auditory function at various frequencies and speech recognition thresholds (SRT) against Mini‐Mental State Examination (MMSE) scores.MethodWe analyzed data from the CHOICE‐Cohort study (Chinese Hearing Solution for Improvement of Cognition in Elders), which comprised 17,057 individuals aged 60 and older. Pure tone audiometry was employed to determine hearing thresholds across frequencies from 0.25 kHz to 8 kHz. The SRT was defined as the lowest sound intensity at which participants correctly identified 50% of monosyllabic words. Cognitive function was assessed using the MMSE, and Pearson correlation coefficients were used to evaluate the relationships between hearing metrics and cognitive scores.ResultSignificant negative correlations were observed between auditory thresholds in the better ear and MMSE scores (correlation coefficients between 0.18 and 0.26), particularly stronger at mid and low frequencies than at high frequencies. Furthermore, SRT correlated more strongly with MMSE scores across different cognitive subdomains than pure tone thresholds, indicating that speech recognition may be a more sensitive marker of cognitive health. Additionally, cognitive functions involving orientation, registration, and language were more closely associated with hearing than recall and calculation tasks.ConclusionThe findings suggest that SRT is more closely correlated with MMSE scores than pure tone thresholds, underscoring the importance of including speech audiometry in routine cognitive assessments for older people.

BACKGROUND Congenital cholesteatoma is a relatively rare condition accounting for about 2% to 5% of all cholesteatomas. Congenital cholesteatomas pose a significant challenge to treat. Failure to detect cholesteatoma early can lead to progressive and severe damage to middle ear structures, resulting in hearing loss. If conventional hearing aids are not a viable option, a bone conduction implant may be considered. One of the most successful is the Bonebridge implant, designed for adults and children with conductive or mixed hearing loss. The aim of this study was to analyze the surgical implications, efficacy, and safety of the Bonebridge implant in our patient. CASE REPORT We report the case of a 10-year-old girl with a diagnosis of congenital cholesteatoma and progressive hearing loss. She had undergone multiple surgical procedures, with no lasting results. To improve hearing, she underwent a comprehensive diagnostic evaluation for an implantable bone conduction device, and she was found to be eligible for a Bonebridge implant. To verify the improvement in hearing, pure-tone audiometry, speech audiometry, and the Polish Matrix Sentence Test were performed before implantation, during processor activation, and at the follow-up visit 3 months later. Follow-up was planned at 3 and 6 months to monitor for recurrence of cholesteatoma, with cavity checks every 4 weeks. CONCLUSIONS After Bonebridge implantation, the patient demonstrated significant improvement in hearing thresholds and speech recognition. Implantation was uncomplicated and regular follow-ups were scheduled to monitor for recurrent cholesteatoma.

Sudden sensorineural hearing loss constitutes an otologic emergency characterized by a rapid hearing decline of at least 30 dB across three contiguous frequencies within less than 72 hours. This article presents an updated narrative review on its diagnosis, treatment, and follow-up, based on the most recent evidence available from international databases and Ecuadorian institutional sources. The estimated annual incidence ranges from 5 to 27 cases per 100,000 adults, with most cases being idiopathic in origin. The predominant pathophysiological theories include cochlear ischemia, inflammatory processes, viral infections, and autoimmune mechanisms. Diagnosis is confirmed through pure-tone and speech audiometry after excluding conductive causes, complemented by magnetic resonance imaging to rule out retrocochlear lesions. Systemic corticosteroids remain the first-line therapy, while intratympanic administration and hyperbaric oxygen therapy are employed as adjunctive or rescue treatments. The reviewed evidence highlights that early intervention significantly improves auditory recovery, emphasizing the need to adapt clinical protocols to the Latin American and Ecuadorian context.

Objectives: Dementia and hearing loss are prevalent conditions among older adults. This study aimed to determine the association between hearing loss and cognitive status using data from the Catholic Medical Center Clinical Data Warehouse (CMC–CDW). Methods: A retrospective review was conducted using the CMC–CDW. A total of 801 participants, aged 60 years and older, underwent bilateral speech audiometry and cognitive assessments using the Korea Mini-Mental State Examination (K–MMSE) and the Seoul Neuropsychological Screening Battery (SNSB). Results: The mean age of the participants was 77.1 ± 9.7 years, and the sex distribution was 313 males and 488 females. The mean speech recognition threshold was 39.6 ± 4.8 dB, and the average speech discrimination score was 74.3 ± 29.9%. The mean K–MMSE score was 25.1 ± 4.3. Cognitive status was categorized as normal (n = 205), mild cognitive impairment (n = 438), and dementia (n = 158). Logistic regression revealed that age, sex, and hearing loss were significantly associated with cognitive impairment (p < 0.05). Conclusions: These findings suggest that the association between hearing loss and cognitive impairment may be observed even at a mild stage of hearing loss, highlighting the need for early evaluation and management in older adults.

This study aimed to compare the efficacy and safety of different types of intratympanic corticosteroids for treating idiopathic sensorineural hearing loss (ISSNHL). MEDLINE/PubMed, Cochrane Central Register of Controlled Trials, and the Web of Science databases were systematically searched for clinical trials and cohort studies published from inception until the 28th of October 2024. The outcomes included the change in mean hearing threshold with pure tone audiometry (PTA average) (primary) as well as the percentage of patients with improved hearing, the final hearing threshold with PTA, the change in hearing threshold with speech audiometry, and adverse events. (secondary). The results were pooled as standardized mean difference (SMD) and risk ratio (RR) for numerical and dichotomous outcomes, respectively. Eleven studies were included. The pooled results did not reveal a significant improvement in PTA average with methylprednisolone compared to dexamethasone (number of studies = 5; number of participants = 430; pooled SMD [95% CI] = 0.31 [-0.10, 0.72], P = 0.100). The results showed that methylprednisolone was significantly associated with achieving satisfactory response (complete or partial recovery) (number of studies = 6; number of participants = 498; pooled RR [95% CI] = 1.32 [1.11, 1.56], P = 0.002). The current evidence suggests that methylprednisolone potentially possesses an efficacy advantage compared to dexamethasone in terms of higher recovery rates in patients with ISSNHL. The evidence quality is downgraded by the limitations of the included studies and the observed wide clinical heterogeneity. There is a need for the conduct of high-quality randomized clinical trials to investigate the superiority of intratympanic methylprednisolone compared to intratympanic dexamethasone in patients with ISSNHL.

BackgroundHearing deficit is one of the side effects of 1st generation iron chelators in β-thalassemia, however the risk of hearing deficits following 2nd generation iron chelators is not well known.AimTo assess hearing status of Transfusion Dependent β-thalassemia children on oral iron chelating agents and detect risk factors for hearing impairment.MethodsThis is a cross-sectional study recruited sixty children and adolescent with confirmed diagnosis of transfusion dependent β-thalassemia. Demographic and clinical characteristics collected, audiological testing were performed by the same audiologist using the same equipment for all patients including tympanometry, pure tone audiometry, speech audiometry, transient evoked otoacoustic emissions and distortion product otoacoustic emissions.ResultsRecruited children and adolescents with transfusion dependent β-thalassemia were 32 (53.3%) boys and 28 (46.7%) girls and their mean age was 11.34 ± 3.08, majority of patients 48 (80%) were on single Deferasirox. Our study revealed that among the 60 children evaluated, 16.6% exhibited some form of hearing loss. Sensorineural hearing loss (SNHL) was observed in 6.6% of the participants, while 10% had conductive hearing loss (CHL). Bilateral SNHL in 5% and bilateral CHL in 8.3% of all the cases. Hearing impairment was mild in nature, but predominantly affected high-frequency ranges, the most affected frequencies being 4000 Hz and 8000 Hz. There was no significant difference between studied thalassemia children with and without hearing impairment regarding gender, age at study entry, age at diagnosis, duration of disease and duration or dose of chelating agent (P > 0.05). Our study revealed significant difference between studied thalassemia children with and without hearing impairment regarding age of starting blood transfusion (p-value = 0.024), affected patients started blood transfusion at older age, also statistically significant difference in both groups regarding median serum ferritin was found (p-value = 0.028), lower levels were found in affected patients.ConclusionNo significant effect of using oral iron chelation drugs was observed on frequency and type of hearing loss among the studied patients but instead the age at starting regular blood transfusion did. Screening of such group of patients for hearing impairment at diagnosis and at regular periods is recommended.

Abstract Context: Children with sensorineural hearing loss (HL) are at risk for difficulties in language, cognition, and academic learning, particularly in mathematics. Early diagnosis and rehabilitation have improved auditory and verbal outcomes, but less is known about their effects on mathematical skills. Aims: This study aims to assess the mathematical skills in children with and without HL through the standardized BDE-2 test and to explore the potential correlations between audiological parameters and cognitive-mathematical performance. Settings and Design: A case–control study was performed on 37 children aged between 9 and 15 years, enrolled at the Audiology and Phoniatrics Unit of the University of Naples Federico II. Subjects and Methods: The sample included 25 children with bilateral sensorineural HL (study group) and 12 normal-hearing peers (control group). Each participant underwent a full audiological assessment – comprising unaided and aided pure-tone and speech audiometry – and completed the BDE-2 test. The two groups were compared in terms of mathematical skills, and correlations were analyzed between the degree of HL and BDE-2 assessment. Statistical Analysis Used: Chi-square, Fisher’s exact, t -test, Mann–Whitney, Wilcoxon, and Spearman correlation coefficients were applied. Significance was set at P &lt; 0.05. Results: Children with HL scored significantly lower in calculation (75.4 ± 22.9 vs. 95.0 ± 12.7; P = 0.0021) and in total BDE-2 (82.2 ± 21.9 vs. 95.2 ± 6.9; P = 0.0113) indices than controls, while differences in number recognition and sense were not statistically significant. No correlations emerged between HL severity and BDE-2 outcomes. All children with HL showed a statistically significant improvement in pure-tone thresholds and speech recognition when tested with hearing aids or cochlear implants. Conclusions: Despite modern rehabilitative technologies, children with HL exhibit persistent weaknesses in complex calculation and global mathematical performance. Early screening and interventions targeting linguistic, mnemonic, and symbolic reasoning abilities should be integrated into standard follow-up programs to enhance academic outcomes.

Effectiveness of unilateral cochlear implantation in people over 60 years.

ABSTRACTObjectivesThe individual mapping of cochlear implants (CIs) aims to optimize the user's speech understanding. Recent investigations have shown the importance of soft speech: (1) According to Datalog studies, a large proportion of speech components lies in the range below 60 dB, and (2) soft speech represents a separate category in CI outcome, in addition to supra‐threshold speech and speech in noise. Soft‐speech understanding can be influenced by optimizing T‐values or by global parameters (loudness growth and TSPL in the Nucleus system). This study focussed on improving soft speech below 60 dB by optimizing loudness growth.MethodsSpeech understanding with varying loudness growth in the speech processor CP11 (Cochlear Ltd.) was compared in 20 experienced adult CI users. The mean soft‐speech score based on monosyllabic words at 40 and 50 dB was introduced for quantification.ResultsSix of the 20 patients studied showed significant individual improvement for soft speech when loudness growth was optimized, while none showed a significant decrease under quiet or noisy test conditions.ConclusionActual CI systems offer a broad loudness range of speech understanding. In addition to suprathreshold speech understanding, additional attention should be paid to soft speech, and the result should therefore be confirmed by speech audiometry at low levels.Levels of Evidence2.

Objective:To explore the application value of P1 response threshold of cortical auditory evoked potential（CAEP） in evaluating the rehabilitation effect of cochlear implant in young children. Methods:Thirty-three young children after cochlear implantation were divided into groups according to hearing age: Group A（hearing age 1-<2 years old） 10 people; Group B（hearing age 2-<3 years old） 13 people; Group C（hearing age 3-<4 years old） 10 people. The subjective assessment was carried out using the assessment tool for hearing-impaired children- "Criteria and Methods for assessing Auditory and language ability of hearing-impaired children" and objective electrophysiological examination was carried out using CAEP to evaluate the rehabilitation effect. SPSS 25.0 software was used for statistical analysis. Results:The results of subjective assessment of auditory ability and language ability in each group showed an increasing trend with the increase of auditory age. In this study, the P1 response threshold of CAEP in CI implanted children had a significant positive correlation with the 2 kHz hearing threshold after intervention, and the P1 response threshold of CAEP was negatively correlated with many items in subjective auditory ability and language ability assessment. Conclusion:The P1 response threshold of CAEP has a stable correlation with the results of speech audiometry, which can effectively and objectively evaluate the postoperative rehabilitation effect of young children with cochlear implantation.

Background: Urdu has historically lacked validated speech audiometry materials, limiting clinicians to improvised and unreliable tests. Recently developed Urdu spondee and monosyllabic word lists have been validated in normal-hearing listeners. This study evaluated their clinical utility in hearing-impaired adults. Methods: Forty Urdu-speaking adults aged 18–60 years including conductive loss (n=10), mild sensorineural hearing loss (SNHL; n=10), moderate SNHL (n=10), and moderately severe SNHL (n=10) and with bilateral hearing loss were recruited in the study. Pure-tone audiometry was used as an established threshold. Speech Reception Thresholds (SRT) were measured using the Urdu spondee list. While Word Recognition Scores (WRS) were assessed using validated monosyllabic lists at four intensity levels (10 dB above SRT to 5 dB below uncomfortable loudness level). Results: pure-tone averages as SRTs raised systematically with severity and closely matched, the mild SNHL 34.5±3.7 dB (PTA 35.6±4.8), moderate SNHL 49.5±3.7 dB (PTA 52.5±3.8), moderately severe SNHL 62.1±2.5 dB (PTA 63.6±4.2), and conductive HL 42.0±5.4 dB (PTA 45.0±5.0). Word recognition improved with intensity across all groups. Conductive HL achieved the highest scores up to 100%, mild SNHL up to 89%, moderate SNHL up to 78%, and moderately severe SNHL up to 69%. Performance-intensity curves showed up a plateau at higher levels with no rollover. Conclusions: The Urdu spondee and monosyllabic lists yielded results consistent with audiological norms. SRTs agreed closely with audiometric thresholds, and WRS patterns reflected hearing loss type and severity. These findings validate the new Urdu materials as reliable clinical tools for Urdu-speaking patients with hearing impairment.

Objective: To develop a set of Mongolian monosyllabic word lists suitable for measuring Word Recognition Scores (WRS) and to evaluate their validity using psychometric function analysis. Methods: In the first phase, 220 Mongolian monosyllabic words that are widely recognized and commonly used in daily conversations by the general population were selected from various linguistic sources and phonemically balanced. A professional female voice artist digitally recorded these words in a sound studio, and their intensity levels were normalized using the Root Mean Square (RMS) value at 1000 Hz. In the second phase, word recognition tests were administered to 50 participants with normal hearing, aged 18 to 29 years. The tests took place in a sound-treated booth, with words presented at intensity levels ranging from –4 to 18 dB HL in 2 dB steps. The 220 words were randomly divided into four blocks of 55 words each. In the third phase, psychometric functions were generated using logistic regression analysis. To determine statistical differences between the lists and half-lists, chi-square (χ²) tests and one-way analysis of variance (ANOVA) were used. Results: From the original pool of 220 words, the 200 most perceptible monosyllabic words were selected based on recognition accuracy across presentation levels. These were divided into four balanced 50-word lists and eight 25-word half-lists. Psychometric functions were calculated for each list using logistic regression. The average slope at the 50% threshold was 10.43%/dB, and the slopes between 20% and 80% recognition ranged from 8.61 to 9.38%/dB. Statistical analyses showed no significant differences in recognition scores or intensity levels across lists and half-lists, confirming their equivalence. Intensity adjustments (≤ ±0.3 dB) were applied to standardize the 50% threshold across all lists (mean=6.16 dB HL). The results demonstrate that the developed Mongolian monosyllabic lists are phonetically and perceptually homogeneous, making them suitable for clinical and research use. Conclusions: This study developed a standardized set of Mongolian monosyllabic word lists with consistent psychometric properties. These materials are suitable for use by otologists and audiologists in clinical assessments and speech audiometry research in Mongolia.

Background/Objectives: The Matrix Sentence Test is an audiological evaluation that quantifies the signal-to-noise ratio, expressed in decibels, at which the patient comprehends 50% of the words of a random sentence heard in noise. It is an effective and reliable tool for cochlear implant fitting and follow-up in both adults and children, demonstrating reliability upon repeated administration. A simplified model of the Matrix Sentence Test can be used in children. This study had two main objectives: first, to evaluate the Simplified Matrix Sentence Test for objectively estimating post-fitting CI performance; and second, to assess the influence of various demographic and device-related variables on the results. The variables of interest included gender, manufacturer, placement, microphone position, array position, score in pre-fitting speech audiometry in quiet, age at first implantation, age at test administration, and the interval between the first implant and the test administration. Methods: A retrospective study of pediatric patients with cochlear implants was performed. The inclusion criteria were patients aged 7–18 years, with a minimum of two years of cochlear implantation, adequate Italian language proficiency, and regular follow-up attendance. The subjects were administered the Simplified Matrix Sentence Test prior to and following map fitting by an experienced audiologist. Results: The study’s sample population included 51 patients who met the established inclusion criteria, with an average age of 13 years. In the preliminary SiIMax test, the average SNR for 50% sentence comprehension in noise was −0.83 ± 1.86 dB. Map adjustments included reductions or increases in comfort and threshold levels, modifications to multiple electrodes, or minor secondary changes. Approximately two days later, the second Simplified Matrix Sentence Test was administered. The average signal-to-noise for sentence comprehension was −2.05 ± 1.73 dB. Univariate and multivariate analyses revealed that no variable had a statistically significant impact on the results. Conclusions: The Simplified Matrix Sentence Test demonstrated universal applicability in compliant patients. Post-implant improvement appeared independent of patient demographics and device variables.

Hearing plays a key role not only in the perception of information from the environment and the formation of speech, but also in social construction, communication and the maintenance of important cognitive functions. At the same time, persistent hearing loss can lead to cognitive disorders and dementia, as well as central auditory dysfunction. Subjective methods of hearing research were used - pure tone threshold audiometry (PTA), speech audiometry in silence and noise; and objective diagnostics - recording of long-latency auditory evoked potentials (LLAEP). Hearing aid rehabilitation of patients with bilateral hearing loss leads not only improve the quality of life, but also helps to prevent disorders of memory and attention. Clinical examples show the difference in speech intelligibility between patients with permanent hearing loss rehabilitated with one and two hearing aids, as measured by speech audiometry. In addition, it is investigated whether the side of the prosthesis affects the state of the cortical centers of the auditory analyzer as measured by long-latency auditory evoked potentials (LLAEPs).

The discrepancy between the hearing aid benefit estimated in standard audiological tests, like speech audiometry, and the perceived benefit in daily life has led to interest in methods better reflecting real-world performance. In contrast to audiological tests, everyday communication commonly takes place in enclosed spaces with acoustic reflections and multiple sound sources, including sounds from adjoining rooms through open doors. This study investigates speech recognition thresholds (SRTs) with a sentence test in a laboratory environment resembling an average German living room with an adjacent kitchen. Additionally, acoustic simulations of the environment were presented in a large-scale (86) and small-scale (4) loudspeaker array, with the latter feasible for a clinical context. Measurements with normal-hearing and hearing-impaired listeners were conducted using different spatial target positions and a fixed masker position. One of the target positions was within the adjacent kitchen without line-of-sight to the sound source, representing a challenging acoustic configuration. Hearing-impaired listeners performed the measurements with and without their hearing aids. SRTs were compared between different presentation settings and to those measured in standard free-field audiological spatial configurations (S0N0, S0N90). An auditory model was employed for further analysis. Results show that SRTs in the simulated living room environment with 86 and 4 loudspeakers matched the real environment, even for aided listeners, indicating that virtual acoustics representations can reflect real-world listening performance. When signal-to-noise ratios were normalized, the measured hearing aid benefit did not differ significantly between the standard audiological spatial configuration S0N90 and any spatial configuration in the living room environment.

ObjectivesThis study aimed to analyze the relationship between tinnitus and speech audiometry results.Materials and methodsIn this investigation, 314 patients with primary subjective tinnitus and 279 patients with sensorineural hearing loss, serving as a control group, were enrolled. All participants underwent comprehensive assessments, which included pure-tone and speech audiometry.ResultsIn considering basic parameters, a slight predominance of females was noted in both groups, with left-sided and bilateral tinnitus being the most common types. There were no significant differences in pure-tone averages between the tinnitus and control groups. In the tinnitus group, speech audiometry intensity were significantly higher (p < 0.00001) compared to the control group. In analyzing the relationships between tinnitus intensities and speech audiometry intensity, a significant (p = 0.000) positive correlation (rho = 0.581) was revealed. Additionally, a significant (p = 0.027) positive correlation (rho = 0.227) was found between tinnitus intensities and Tinnitus Handicap Inventory scores.ConclusionThe relationship between tinnitus intensities and speech audiometry intensity demonstrates how tinnitus affects speech comprehension. Additionally, the intensity of tinnitus significantly influences an individual’s perception of tinnitus severity.

Speech audiometry in noise: Signal noise ratio loss values according speech signal level presentation in normal hearing subjects.