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Audiol. Res., Volume 14, Issue 3 (June 2024) – 12 articles

Cover Story (view full-size image): Cognitive Behavioural Therapy (CBT) has received strong support as an intervention for tinnitus, at least when provided by psychologists; much less is known about the efficacy of CBT for tinnitus when provided by audiologists. This has been identified as a priority research question within the area of tinnitus as it is widely recognized that audiologists are often key figures in tinnitus care. This review maps the existing body of literature regarding audiologist-provided CBT, and in particular outlines how audiologist-provided CBT programs have been structured and conducted, and how they have been explored in research. It also highlights area for future research, most notably the efficacy of audiologist- vs. psychologist-provided CBT for tinnitus. View this paper
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9 pages, 375 KiB  
Brief Report
Acceptability of Audiovestibular Assessment in the Home—A Patient Survey
by Amanda J. Male, Nehzat Koohi, Sarah L. Holmes, Robert D. S. Pitceathly and Diego Kaski
Audiol. Res. 2024, 14(3), 545-553; https://doi.org/10.3390/audiolres14030045 - 20 Jun 2024
Viewed by 381
Abstract
The COVID-19 pandemic dramatically changed health service delivery with vulnerable patients advised to isolate and appointments provided virtually. This change affected recruitment into an observational cohort study, undertaken at a single site, where participants with mitochondrial disorders were due to have specialist hospital-based [...] Read more.
The COVID-19 pandemic dramatically changed health service delivery with vulnerable patients advised to isolate and appointments provided virtually. This change affected recruitment into an observational cohort study, undertaken at a single site, where participants with mitochondrial disorders were due to have specialist hospital-based audiovestibular tests. To ensure study viability, the study protocol was amended to allow home-based assessment for vulnerable participants. Here, we report outcomes of an online survey of participants who underwent home-based assessment, related to the experience, perceived benefits, and drawbacks of home audiovestibular assessments. Seventeen participants underwent home-based neuro-otological assessment, due to the need to isolate during COVID-19. Following the assessment, 16 out of 17 participants completed an anonymised online survey to share their experiences of the specialist home-based assessment. One hundred percent of participants rated the home-based assessment ‘very positively’ and would recommend it to others. Sixty-three percent rated it better than attending hospital outpatient testing settings. The benefits included no travel burden (27%) and reduced stress (13%). A majority reported no drawbacks in having the home visit. The patient-reported feedback suggests a person-centred approach where audiovestibular assessments are conducted in their homes is feasible for patients, acceptable and seen as beneficial to a vulnerable group of patients. Full article
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27 pages, 14579 KiB  
Perspective
A New Perspective to Interpret How the Vestibular Efferent System Correlates the Complexity of Routine Balance Maintenance with Management of Emergency Fall Prevention Strategies
by Neil S. Longridge and Arthur I. Mallinson
Audiol. Res. 2024, 14(3), 518-544; https://doi.org/10.3390/audiolres14030044 - 18 Jun 2024
Viewed by 660
Abstract
Bipedalism is unique among mammals. Until modern times, a fall and resulting leg fracture could be fatal. Balance maintenance after a destabilizing event requires instantaneous decision making. The vestibular system plays an essential role in this process, initiating an emergency response. The afferent [...] Read more.
Bipedalism is unique among mammals. Until modern times, a fall and resulting leg fracture could be fatal. Balance maintenance after a destabilizing event requires instantaneous decision making. The vestibular system plays an essential role in this process, initiating an emergency response. The afferent otolithic neural response is the first directionally oriented information to reach the cortex, and it can then be used to initiate an appropriate protective response. Some vestibular efferent axons feed directly into type I vestibular hair cells. This allows for rapid vestibular feedback via the striated organelle (STO), which has been largely ignored in most texts. We propose that this structure is essential in emergency fall prevention, and also that the system of sensory detection and resultant motor response works by having efferent movement information simultaneously transmitted to the maculae with the movement commands. This results in the otolithic membrane positioning itself precisely for the planned movement, and any error is due to an unexpected external cause. Error is fed back via the vestibular afferent system. The efferent system causes macular otolithic membrane movement through the STO, which occurs simultaneously with the initiating motor command. As a result, no vestibular afferent activity occurs unless an error must be dealt with. Full article
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11 pages, 728 KiB  
Review
Congenital Cytomegalovirus-Related Hearing Loss
by Nicoleta Gana, Iulia Huluță, Mihai-Ștefan Cătănescu, Livia-Mihaela Apostol, Florina Mihaela Nedelea, Romina-Marina Sima, Radu Botezatu, Anca Maria Panaitescu and Nicolae Gică
Audiol. Res. 2024, 14(3), 507-517; https://doi.org/10.3390/audiolres14030043 - 16 Jun 2024
Viewed by 587
Abstract
Congenital hearing loss is a significant global health concern that affects millions of newborns and infants worldwide, posing substantial challenges for affected individuals, their families, and healthcare systems. This condition, present at birth, can stem from genetic factors, in utero exposures, infections, or [...] Read more.
Congenital hearing loss is a significant global health concern that affects millions of newborns and infants worldwide, posing substantial challenges for affected individuals, their families, and healthcare systems. This condition, present at birth, can stem from genetic factors, in utero exposures, infections, or complications during pregnancy or childbirth. The spectrum of congenital hearing loss ranges from mild to profound, impacting the development of speech, language, and cognitive skills, thereby influencing educational achievements, social integration, and future employment opportunities. Early detection and intervention strategies, such as newborn hearing screenings, genetic counseling, and the use of hearing aids or cochlear implants, are crucial for mitigating these impacts. This review article aims to explore the diagnostic approaches and management strategies for congenital cytomegalovirus-related hearing loss, emphasizing the importance of interdisciplinary care and the potential for technological advances to improve outcomes for affected individuals. Full article
(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)
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2 pages, 182 KiB  
Reply
Reply to Hornibrook, J. Comment on “Tabet et al. Vestibular Migraine versus Méniere’s Disease: Diagnostic Utility of Electrocochleography. Audiol. Res. 2023, 13, 12–22”
by Issam Saliba and Paul Tabet
Audiol. Res. 2024, 14(3), 505-506; https://doi.org/10.3390/audiolres14030042 - 30 May 2024
Viewed by 320
Abstract
We appreciate the comments made by Hornibrook (2024) [...] Full article
12 pages, 1465 KiB  
Article
Assessment of Outer and Middle Ear Pathologies in Lilongwe, Malawi
by Ruth Mtamo, Jenna Vallario, Ambuj Kumar, Jesse Casanova and Julia Toman
Audiol. Res. 2024, 14(3), 493-504; https://doi.org/10.3390/audiolres14030041 - 30 May 2024
Viewed by 333
Abstract
Outer and middle ear pathologies are known to disproportionately affect low-income countries but data is limited. We aim to quantify the prevalence rate of patients presenting with middle/outer ear pathologies at ABC Hearing Clinic and Training Centre in Lilongwe, Malawi. Audiological consultations (adult [...] Read more.
Outer and middle ear pathologies are known to disproportionately affect low-income countries but data is limited. We aim to quantify the prevalence rate of patients presenting with middle/outer ear pathologies at ABC Hearing Clinic and Training Centre in Lilongwe, Malawi. Audiological consultations (adult and paediatric) from 2018–2020 were reviewed for outer and middle ear pathologies. Secondary outcomes included patient type (private vs. community) compared to otoscopy findings, tympanometry findings, need for follow up, and follow up compliance. Out of 1576 patients reviewed, the proportion of abnormal cases’ was 98.2%, with 41.4% being unilateral and 57.4% bilateral. Eighty-three percent presented with outer/middle ear pathologies. 68% of those presented with a pathology often associated with some degree of conductive hearing loss (occluding wax, perforation, discharge, Type B/Type C tympanogram). Average age was 29 + 0.527 years; 41.6% private and 58.2% community patients. Cerumen impaction was most common finding (51%). Higher rates of otoscopic abnormalities and type B tympanograms were noted in community vs. private patient (~40% vs. ~30%; ~70% vs. ~30%). Adherence to follow up was higher for community vs. private patients (29% vs. 17%); ~70% reported subjective improvement upon follow up. The majority required multiple interventions on follow up. Secondary follow up was recommended in 64.8%. A significant disease burden of outer and middle ear pathologies was identified. Further research is required to understand the disease burden and promote health policy. Full article
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14 pages, 232 KiB  
Perspective
Hearing Loss and Cognitive Decline in the Aging Population: Emerging Perspectives in Audiology
by Naveen K. Nagaraj
Audiol. Res. 2024, 14(3), 479-492; https://doi.org/10.3390/audiolres14030040 - 23 May 2024
Viewed by 763
Abstract
In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer’s disease [...] Read more.
In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer’s disease is discussed, with the aim of enhancing our understanding of these interconnected conditions. Highlighting the evolving significance of audiologists in the dual management of cognitive health and hearing impairments, the author focuses on their role in identifying early signs of cognitive impairment and evaluates various cognitive screening tools used in this context. The discussion extends to adaptations of hearing assessments for older adults, especially those diagnosed with dementia, and highlights the significance of objective auditory electrophysiological tests. These tests are presented as vital in assessing the influence of aging and Alzheimer’s disease on auditory processing capabilities and to signal cognitive dysfunction. The article underscores the critical role of audiologists in addressing the challenges faced by the aging population. The perspective calls for further research to improve diagnostic and therapeutic strategies in audiology, and emphasizes the need for a multidisciplinary approach in tackling the nexus of hearing loss, auditory processing, and cognitive decline. Full article
(This article belongs to the Special Issue Cognitive Decline within the Audiology Scope of Practice)
10 pages, 912 KiB  
Article
Comparison of Psychometric Functions Measured Using Remote Testing and Laboratory Testing
by Nirmal Srinivasan, Chhayakanta Patro, Radhika Kansangra and Angelica Trotman
Audiol. Res. 2024, 14(3), 469-478; https://doi.org/10.3390/audiolres14030039 - 22 May 2024
Viewed by 703
Abstract
The use of remote testing to collect behavioral data has been on the rise, especially after the COVID-19 pandemic. Here we present psychometric functions for a commonly used speech corpus obtained in remote testing and laboratory testing conditions on young normal hearing listeners [...] Read more.
The use of remote testing to collect behavioral data has been on the rise, especially after the COVID-19 pandemic. Here we present psychometric functions for a commonly used speech corpus obtained in remote testing and laboratory testing conditions on young normal hearing listeners in the presence of different types of maskers. Headphone use for the remote testing group was checked by supplementing procedures from prior literature using a Huggins pitch task. Results revealed no significant differences in the measured thresholds using the remote testing and laboratory testing conditions for all the three masker types. Also, the thresholds measured obtained in these two conditions were strongly correlated for a different group of young normal hearing listeners. Based on the results, excellent outcomes on auditory threshold measurements where the stimuli are presented both at levels lower than and above an individual’s speech-recognition threshold can be obtained by remotely testing the listeners. Full article
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12 pages, 1147 KiB  
Article
Hebrew Digits in Noise (DIN) Test in Cochlear Implant Users and Normal Hearing Listeners
by Riki Taitelbaum-Swead and Leah Fostick
Audiol. Res. 2024, 14(3), 457-468; https://doi.org/10.3390/audiolres14030038 - 20 May 2024
Viewed by 481
Abstract
This study aimed to compare the Hebrew version of the digits-in-noise (DIN) thresholds among cochlear implant (CI) users and their normal-hearing (NH) counterparts, explore the influence of age on these thresholds, examine the effects of early auditory exposure versus its absence on DIN [...] Read more.
This study aimed to compare the Hebrew version of the digits-in-noise (DIN) thresholds among cochlear implant (CI) users and their normal-hearing (NH) counterparts, explore the influence of age on these thresholds, examine the effects of early auditory exposure versus its absence on DIN threshold, and assess the correlation between DIN thresholds and other speech perception tests. A total of 13 children with CI (aged 5.5–11 years), 15 pre-lingual CI users (aged 14–30 years), and 15 post-lingual CI users (aged 22–77 years), and their age-matched NH controls (n = 45) participated in the study. Speech perception tasks, including the DIN test, one-syllable word test, and sentence identification tasks in various auditory conditions, served as the main outcome measures. The results indicated that CI users exhibited higher speech reception thresholds in noise across all age groups compared to NH peers, with no significant difference between pre-lingual and post-lingual CI users. Significant differences were also observed in monosyllabic word and sentence accuracy in both quiet and noise conditions between CI and NH groups. Furthermore, correlations were observed between the DIN and other speech perception tests. The study concludes that CI users require a notably higher signal-to-noise ratio to discern digits in noise, underscoring the DIN test’s utility in assessing speech recognition capabilities in CI users while emphasizing the need for a comprehensive test battery to fully gauge their speech perception abilities. Full article
(This article belongs to the Special Issue Rehabilitation of Hearing Impairment: 2nd Edition)
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15 pages, 2338 KiB  
Article
Evolution of Hyperventilation-Induced Nystagmus in Acute Unilateral Vestibulopathy—Interpretative Model and Etiopathogenetic Hypotheses
by Francesco Frati, Alessandra D’Orazio, Valeria Gambacorta, Giacomo Ciacca, Giampietro Ricci and Mario Faralli
Audiol. Res. 2024, 14(3), 442-456; https://doi.org/10.3390/audiolres14030037 - 18 May 2024
Viewed by 700
Abstract
Hyperventilation induces metabolic changes that can elicit nystagmus (hyperventilation-induced nystagmus, HVIN) in various vestibular disorders, revealing vestibular imbalance and bringing out central or peripheral asymmetries. In acute unilateral vestibulopathy (AUVP, namely vestibular neuritis), hyperventilation can induce different patterns of nystagmus (excitatory, inhibitory, or [...] Read more.
Hyperventilation induces metabolic changes that can elicit nystagmus (hyperventilation-induced nystagmus, HVIN) in various vestibular disorders, revealing vestibular imbalance and bringing out central or peripheral asymmetries. In acute unilateral vestibulopathy (AUVP, namely vestibular neuritis), hyperventilation can induce different patterns of nystagmus (excitatory, inhibitory, or negative), disclosing or modifying existing static vestibular asymmetries through its ability to invalidate compensation or increase peripheral excitability. In this context, we followed the evolutionary stages of HVIN in AUVP across 35 consecutive patients, with the goal of assessing alterations in the oculomotor pattern caused by hyperventilation over time. In the acute phase, the incidence of the excitatory pattern (and the strongly excitatory one, consisting of a reversal nystagmus evoked by hyperventilation) was significantly higher compared to the inhibitory pattern; then, a progressive reduction in the incidence of the excitatory pattern and a concomitant gradual increase in the incidence of the inhibitory one were observed in the follow-up period. Assuming the role of the ephaptic effect and the transient loss of vestibular compensation as opposing mechanisms, i.e., excitatory and inhibitory, respectively, the oculomotor pattern evoked by hyperventilation is the result of the interaction of these two factors. The data obtained allowed us to hypothesize an interpretative model regarding the pathogenetic aspects of responses evoked by hyperventilation and the etiologies of the disease: according to our hypotheses, the excitatory pattern implies a neuritic (viral) form of AUVP; instead, the inhibitory (and negative) one can be an expression of both the neuritic (viral) and vascular forms of the disease. Full article
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10 pages, 1025 KiB  
Article
Posterior Semicircular Canal Plugging Relieves Tumarkin’s Crisis in Ménière’s Disease Patients
by Francesco Comacchio, Anna Bordin, Valerio Maria Di Pasquale Fiasca, Barbara Bellemo, Paola Magnavita, Elena Fasanaro and Elisabetta Poletto
Audiol. Res. 2024, 14(3), 432-441; https://doi.org/10.3390/audiolres14030036 - 9 May 2024
Viewed by 653
Abstract
(1) Background: Patients affected by Ménière’s disease can experience Tumarkin’s syndrome, which is characterized by postural instability, gait abnormalities, and, occasionally, an abrupt loss of balance known as vestibular drop attack or Tumarkin’s crisis. In this study, semicircular canal plugging is proposed as [...] Read more.
(1) Background: Patients affected by Ménière’s disease can experience Tumarkin’s syndrome, which is characterized by postural instability, gait abnormalities, and, occasionally, an abrupt loss of balance known as vestibular drop attack or Tumarkin’s crisis. In this study, semicircular canal plugging is proposed as the definitive treatment for this condition. The outcomes of this type of surgery are discussed. (2) Methods: A total of 9 patients with a confirmed diagnosis of Ménière disease suffering from Tumarkin crisis underwent posterior semicircular canal plugging. These patients were assessed with Video Head Impulse Tests, vestibular evoked myogenic potentials, and Pure Tone Audiometry preoperatively and postoperatively. (3) Results: VHIT showed a postoperative decrease in PSC gain median (Preop. 0.86 and postop. 0.52; p < 0.009). No statistically significant differences were described for the anterior semicircular canal and the lateral semicircular canal. No patient experienced new Tumarkin crisis after the surgical treatment. (4) Conclusions: Our ten years of experience with posterior semicircular canal plugging in Ménière disease patients with Tumarkin’s syndrome has shown that this type of surgical procedure is successful in controlling Tumarkin’s crisis, with high patient satisfaction and little worsening in hearing level. Full article
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20 pages, 835 KiB  
Review
The Current State of Evidence Regarding Audiologist-Provided Cognitive Behavioural Therapy for the Management of Tinnitus: A Scoping Review
by Louise A. Burke and Amr El Refaie
Audiol. Res. 2024, 14(3), 412-431; https://doi.org/10.3390/audiolres14030035 - 30 Apr 2024
Viewed by 1094
Abstract
Background: Cognitive behavioural therapy (CBT) for tinnitus management is effective and widely recommended by national and international practice guidelines. However, all the evidence for CBT so far has come from Psychologist-led programs, and the potential role of Audiologists in providing CBT for tinnitus [...] Read more.
Background: Cognitive behavioural therapy (CBT) for tinnitus management is effective and widely recommended by national and international practice guidelines. However, all the evidence for CBT so far has come from Psychologist-led programs, and the potential role of Audiologists in providing CBT for tinnitus remains an important consideration. Objectives: This study sets out to systematically map the body of literature relating to Audiologist-provided CBT for tinnitus, in order to summarise the current state of evidence and determine directions for future research. Eligibility criteria: Sources were eligible for inclusion if they addressed the concept of Audiologist-provided CBT. No restrictions were imposed on the date of publication. Only sources published in English were included. Sources of evidence: A wide range of primary and secondary literature sources were sought. Charting methods: Data from included sources were charted systematically using a pre-designed data charting form. Results: Of the 267 identified sources, 30 were included in this review. This included both primary and secondary literature sources. Primary sources were compared and showed variation across Audiologist-provided CBT programs both in terms of procedural details and from a research standpoint. Conclusions: A growing body of evidence has addressed the concept of Audiologist-provided CBT. Directions for future research include further primary research with an increased focus on face-to-face Audiologist-provided CBT, and a comparison of the outcomes of Audiologist-provided vs. Psychologist-provided CBT. Full article
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11 pages, 1831 KiB  
Article
Multi-Magnet Cochlear Implant Technology and Magnetic Resonance Imaging: The Safety Issue
by Pietro Canzi, Elena Carlotto, Elisabetta Zanoletti, Johan H. M. Frijns, Daniele Borsetto, Antonio Caruso, Luisa Chiapparini, Andrea Ciorba, Giorgio Conte, Nathan Creber, Stefania Criscuolo, Filippo Di Lella, Sebastiano Franchella, Erik F. Hensen, Lorenzo Lauda, Stefano Malpede, Marco Mandalà, Liselotte J. C. Rotteveel, Anna Simoncelli, Anna Chiara Stellato, Diego Zanetti and Marco Benazzoadd Show full author list remove Hide full author list
Audiol. Res. 2024, 14(3), 401-411; https://doi.org/10.3390/audiolres14030034 - 26 Apr 2024
Viewed by 661
Abstract
Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) [...] Read more.
Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European survey about this topic was conducted focusing on safety issues, and the results were compared with the current literature. We collected a total of 65 MRI scans performed in 9 otologic referral centers for a total of 47 Hires Ultra 3D recipients, including, for the first time, 2 children and 3 teenagers. Preventive measures were represented by scanning time and sedation for children. Head wrapping was used in eight cases, and six of the eight cases received local anesthesia, even if both measures were not needed. Only three patients complained of pain (3/65 examinations, 4.6%) due to the tight head bandage, and one of the three cases required MRI scan interruption. No other adverse events were reported. We believe that these results should encourage MRI execution in accordance with manufacturer recommendations for Ultra 3D recipients. Full article
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