Audiology Research

18 pages, 4559 KiB

Open AccessArticle

Evaluating Auditory Localization Capabilities in Young Patients with Single-Side Deafness

by Alessandro Aruffo, Giovanni Nicoli, Marta Fantoni, Raffaella Marchi, Edoardo Carini and Eva Orzan

Audiol. Res. 2025, 15(4), 85; https://doi.org/10.3390/audiolres15040085 - 9 Jul 2025

Abstract

Background/Objectives: Unilateral hearing loss (UHL), particularly single-sided deafness (SSD), disrupts spatial hearing in children, leading to academic and social challenges. This study aimed to (1) compare azimuthal sound-localization accuracy and compensatory strategies between children with single-sided deafness (SSD) and their normal-hearing (NH) peers [...] Read more.

Background/Objectives: Unilateral hearing loss (UHL), particularly single-sided deafness (SSD), disrupts spatial hearing in children, leading to academic and social challenges. This study aimed to (1) compare azimuthal sound-localization accuracy and compensatory strategies between children with single-sided deafness (SSD) and their normal-hearing (NH) peers within a virtual reality environment, and (2) investigate sound-localization performance across various azimuths by contrasting left-SSD (L-SSD) and right-SSD (R-SSD) groups. Methods: A cohort of 44 participants (20 NH, 24 SSD) performed sound localization tasks in a 3D virtual environment. Unsigned azimuth error (UAE), unsigned elevation error (UEE), and head movement distance were analyzed across six azimuthal angles (−75° to 75°) at 0°elevation. Non-parametric statistics (Mann–Whitney U tests, Holm–Bonferroni correction) compared performance between NH and SSD groups and within SSD subgroups (L-SSD vs. R-SSD). Results: The SSD group exhibited significantly higher UAE (mean: 22.4° vs. 3.69°, p < 0.0001), UEE (mean: 5.95° vs. 3.77°, p < 0.0001) and head movement distance (mean: 0.35° vs. 0.12°, p < 0.0001) compared with NH peers, indicating persistent localization deficits and compensatory effort. Within the SSD group, elevation performance was superior to azimuthal accuracy (mean UEE: 3.77° vs. mean UAE: 22.4°). Participants with R-SSD exhibited greater azimuthal errors at rightward angles (45°and 75°) and at −15°, as well as increased elevation errors at 75°. Hemifield-specific advantages were strongest at extreme lateral angles (75°). Conclusions: Children with SSD rely on insufficient compensatory head movements to resolve monaural spatial ambiguity in order to localize sounds. Localization deficits and the effort associated with localization task call for action in addressing these issues in dynamic environments such as the classroom. L-SSD subjects outperformed R-SSD peers, highlighting hemispheric specialization in spatial hearing and the need to study its neural basis to develop targeted rehabilitation and classroom support. The hemifield advantages described in this study call for further data collection and research on the topic. Full article

(This article belongs to the Special Issue Breaking Down Listening Barriers for Students with Hearing Difficulties)

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9 pages, 581 KiB

Open AccessArticle

Psychometric Properties of the European Evaluation of Vertigo Scale (EEV) for a Spanish-Speaking Population: A Validation Study

by María Alharilla Montilla-Ibáñez, Rafael Lomas-Vega, María del Carmen López-Ruiz, Ángeles Díaz-Fernández, Alfonso Javier Ibáñez-Vera, Ana Belén Peinado-Rubia, Esteban Obrero-Gaitán and Ana Sedeño-Vidal

Audiol. Res. 2025, 15(4), 84; https://doi.org/10.3390/audiolres15040084 - 8 Jul 2025

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Abstract

Background/Objectives: The objective of this study was to validate the Spanish version of the European Evaluation of Vertigo (EEV) and analyse its test–retest reliability, standard error of measurement (SEM), minimum detectable change (MDC), concurrent validity, and discriminant validity. Methods: A cross-sectional [...] Read more.

Background/Objectives: The objective of this study was to validate the Spanish version of the European Evaluation of Vertigo (EEV) and analyse its test–retest reliability, standard error of measurement (SEM), minimum detectable change (MDC), concurrent validity, and discriminant validity. Methods: A cross-sectional validation study was designed. Subjects were recruited from the Otolaryngology Service of the University Hospital of Jaen. Psychometric properties of the EEV were analysed, including the concurrent validity, the SEM, and the MDC. Discriminant validity was calculated using the receiver operating characteristic (ROC) curve. Results: The EEV test–retest reliability was nearly perfect (Kappa index = 0.97). The SEM and the MDC were set at 0.56 and 1.10, respectively. Regarding the discriminant validity, the area under the curve (AUC) was 0.831 (95% CI; 0.743–0.899) for the BPPV prediction, the AUC = 0.731 (95% CI; 0.633–0.815) for the disability prediction from the ABC-16 score, and the AUC = 0.846 (95% CI; 0.760–0.911) for the disability prediction from the ABC-6 score. Furthermore, a cut-off point greater than 12 was a good predictor of disability and the fall risk measured with the ABC scale, whereas a value of 11 points was a good predictor for discriminating BPPV patients. Conclusions: The Spanish version of the EEV is a valid and reliable instrument for evaluating the clinical symptoms of vestibular syndrome. This instrument demonstrated a nearly perfect test-retest reliability, a low measurement error, and good accuracy in discriminating between patients with vestibular disorders and those with BPPV. Full article

(This article belongs to the Special Issue A New Insight into Vestibular Exploration)

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25 pages, 715 KiB

Open AccessArticle

Cross-Cultural Adaptation and Validation of the Danish Version of Inventory of Hyperacusis Symptoms

by Susanne Steen Nemholt, Camilla Helge, Polly Scutt, David M. Baguley and Jesper Hvass Schmidt

Audiol. Res. 2025, 15(4), 83; https://doi.org/10.3390/audiolres15040083 - 4 Jul 2025

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Abstract

Background/Objectives: This study aimed to (i) cross-culturally adapt the Inventory of Hyperacusis (IHS) into Danish and (ii) assess its usability, validity, and reliability in Danish adults with hyperacusis. Methods: The translation followed established guidelines for adapting hearing-related questionnaires. A two-phase design [...] Read more.

Background/Objectives: This study aimed to (i) cross-culturally adapt the Inventory of Hyperacusis (IHS) into Danish and (ii) assess its usability, validity, and reliability in Danish adults with hyperacusis. Methods: The translation followed established guidelines for adapting hearing-related questionnaires. A two-phase design ensured linguistic and cultural adaptation and evaluated test–retest reliability and construct validity. The IHS, consisting of 25 items, was translated and tested in seven participants through cognitive debriefing. In phase two, temporal consistency was assessed in 32 patients. Results: Thirty-two participants (twenty-eight female; mean age 49.8 years) completed the study over 2–4 weeks (mean 22 days). Eight used hearing aids, and twenty-four reported tinnitus. The Danish IHS showed good reliability (Cronbach’s alpha = 0.95) and acceptable test–retest reliability, except for the General Loudness factor. While no systematic score changes occurred, significant variability in score changes were noted. Conclusions: The Danish IHS appears to be a reliable and valid tool for assessing hyperacusis. Further research is needed, but the IHS-DK shows potential as an effective clinical and research tool for evaluating hyperacusis impact and treatment outcomes. Full article

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18 pages, 578 KiB

Open AccessReview

Sedation Methods in Paediatric Auditory Electrophysiologic Testing: A Narrative Review

by Violeta Necula, Maria Eugenia Domuta, Raluca Olariu, Madalina Gabriela Georgescu, Ioan Florin Marchis, Mirela Cristina Stamate, Cristina Maria Blebea, Maximilian George Dindelegan, Alma Aurelia Maniu and Sever Septimiu Pop

Audiol. Res. 2025, 15(4), 82; https://doi.org/10.3390/audiolres15040082 - 4 Jul 2025

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Abstract

Implementing neonatal hearing screening has significantly reduced the age at which hearing impairments are detected in children. Nevertheless, objective electrophysiological assessments, such as auditory brainstem response (ABR) or auditory steady-state response (ASSR) testing, are often necessary for children older than six months. These [...] Read more.

Implementing neonatal hearing screening has significantly reduced the age at which hearing impairments are detected in children. Nevertheless, objective electrophysiological assessments, such as auditory brainstem response (ABR) or auditory steady-state response (ASSR) testing, are often necessary for children older than six months. These evaluations should be conducted while the child is asleep to obtain accurate and interpretable results, as movement and muscle activity can introduce artifacts that compromise the quality of the recordings. In this narrative review, we evaluate sedation strategies in paediatric procedures, focusing on the efficacy, safety, and practicality of agents/routes for inducing sleep during ABR/ASSR testing. Sedation choices should prioritise patient safety, clinical context, and result reliability and be tailored to the individual’s age, health status, and procedural needs. Full article

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24 pages, 3281 KiB

Open AccessArticle

A Quantitative and Qualitative Analysis of the Phonetic and Phonological Development of Children with Cochlear Implants and Its Relationship with Early Literacy

by Marinella Majorano, Michela Santangelo, Irene Redondi, Chiara Barachetti, Letizia Guerzoni and Domenico Cuda

Audiol. Res. 2025, 15(4), 81; https://doi.org/10.3390/audiolres15040081 - 3 Jul 2025

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Abstract

Background/Objectives: During the transition to primary school, children with cochlear implants (CIs) may show language and early literacy fragilities. This study has three aims. First, it compares the phonetic and phonological skills of preschoolers with CIs and those with normal hearing (NH); [...] Read more.

Background/Objectives: During the transition to primary school, children with cochlear implants (CIs) may show language and early literacy fragilities. This study has three aims. First, it compares the phonetic and phonological skills of preschoolers with CIs and those with normal hearing (NH); second, it investigates the correlation between phonetic/phonological and emergent literacy skills in the two groups; third, it explores the relationship between phonetic/phonological skills and age at implantation in preschoolers with CIs. Methods: Sixteen children with CIs (Mage = 61 months; SD = 6.50) and twenty children with NH (Mage = 64 months; SD = 4.30) participated in the study. Phonetic and phonological skills (phonetic inventories and phonological processes) and early literacy skills (phonological awareness and print knowledge) were assessed. Group differences and relationships between the variables of interest were considered in the two groups. Results: A qualitative analysis of phonetic and phonological development showed differences between the two groups. There were also significant differences in early literacy skills (e.g., in syllable segmentation). Significant correlations emerged in both groups between phonetic/phonological skills and early literacy, although in different variables. Significant correlations were also found between age at implantation and the phonetic inventory in children with CIs. Conclusions: Preschoolers with CIs display more delays in the phonetic and phonological production skills and more emergent literacy fragilities than NH peers. However, print knowledge did not differ significantly between the groups. Early implantation supports the phonetic skills associated with subsequent literacy learning. Full article

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12 pages, 489 KiB

Open AccessSystematic Review

Technologies and Auditory Rehabilitation Beyond Hearing Aids: An Exploratory Systematic Review

by María Camila Pinzón-Díaz, Oswal Martínez-Moreno, Natalia Marcela Castellanos-Gómez, Viviana Cardona-Posada, Frank Florez-Montes, Johnatan Vallejo-Cardona and Luis Carlos Correa-Ortiz

Audiol. Res. 2025, 15(4), 80; https://doi.org/10.3390/audiolres15040080 - 3 Jul 2025

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Abstract

Background: Traditionally, auditory rehabilitation in people with hearing loss has sought training in auditory skills to achieve an understanding of sound messages for communication. Assistive or supportive technology is limited to hearing aids that transmit sound through the air or bone to be [...] Read more.

Background: Traditionally, auditory rehabilitation in people with hearing loss has sought training in auditory skills to achieve an understanding of sound messages for communication. Assistive or supportive technology is limited to hearing aids that transmit sound through the air or bone to be used by the individual, and only in recent times have technologies for rehabilitation, of high cost and difficult access, begun to be used, employed by audiology professionals. Objective: The objective of this study was to compile the evidence reported in the literature on the use of technology in auditory rehabilitation for the improvement of hearing skills in people with hearing loss, beyond hearing aids and cochlear implants. Method: A systematic review of the literature was conducted between 2018 and 2024 in PubMed, Scopus, and Web of Science databases, using as search terms Technology AND “Auditory Rehabilitation” validated in DeCS and MeSH thesauri; the PICO method was used to propose the research question, and the PRISMA strategy was used for the inclusion or exclusion of the articles to be reviewed. Results: In the first search, 141 documents were obtained. Subsequently, inclusion criteria, such as development with vibrotactile stimulation, Information and Communication Technologies (ICTs), among others, and exclusion criteria, such as those related to cochlear implants and air conduction hearing aids, were applied, and finally, articles related to natural language processing, and other systematic reviews were excluded so that the database was reduced to 14 documents. To this set, due to their relevance, two papers were added, for a total of sixteen analyzed. Conclusions: There are solutions ranging from the use of smartphones for telehealth to solutions with multiple technologies, such as the development of virtual environments with vibrotactile feedback. Hearing-impaired people and even professionals in this area of healthcare have a high level of acceptance of the use of technology in rehabilitation. Finally, this article highlights the crucial role of technology in auditory rehabilitation, with solutions that improve hearing skills and the positive acceptance of these tools by patients and audiology professionals. Full article

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18 pages, 3325 KiB

Open AccessArticle

Cochlear Implants and the Aided Audiogram: A Retrospective Study Comparing Performance Across Device Manufacturers

by Nicole Hope Capach, Noam Zigdon, Taylor A. Payne, Jonathan D. Neukam, Yeonjoo Choi, Hong Ju Park, William H. Shapiro and Mario A. Svirsky

Audiol. Res. 2025, 15(4), 79; https://doi.org/10.3390/audiolres15040079 - 2 Jul 2025

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Abstract

Background/Objectives: We investigated: (1) differences in CI-aided thresholds and speech perception scores among cochlear implant manufacturers and (2) the relationship between CI-aided thresholds and speech perception. Methods: We analyzed exploratory data from NYU and a confirmatory data set of 120 CI-aided [...] Read more.

Background/Objectives: We investigated: (1) differences in CI-aided thresholds and speech perception scores among cochlear implant manufacturers and (2) the relationship between CI-aided thresholds and speech perception. Methods: We analyzed exploratory data from NYU and a confirmatory data set of 120 CI-aided audiograms from the ASAN clinic. CI-aided soundfield evaluations were compared between manufacturers (Cochlear, Advanced Bionics, MED-EL) using 5- and 6-pure-tone average thresholds; percentage of patients with average thresholds above 35 dB HL; speech perception scores; and correlations between thresholds and speech perception. Results: Compared to Cochlear users, MED-EL and Advanced Bionics users had significantly higher (poorer) pure-tone averages (26.7 dB HL for Cochlear vs. 30.0 dB HL for AB and 34.6 dB HL for MED-EL at NYU; 29.0 dB HL for Cochlear vs. 36.5 dB HL for MED-EL at ASAN), and higher incidence of 5- or 6-PTAs above 35 dB HL (1.6% vs. 23.4%/47.1% at NYU; 11.2% vs. 60.0% at ASAN). Word and sentence scores were significantly higher for the Cochlear group when compared to the MED-EL group. Speech scores were higher for manufacturers that recommend the use of behaviorally-measured T-levels (Cochlear) rather than estimated T-levels (AB and MED-EL). Significant negative correlations existed between CI-aided thresholds and speech scores. Conclusions: Significant differences in CI-aided thresholds and speech perception were observed between manufacturers, potentially related to brand-specific T-level programming approaches. Full article

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14 pages, 1112 KiB

Open AccessArticle

Individual Noise-Tolerance Profiles and Neural Signal-to-Noise Ratio: Insights into Predicting Speech-in-Noise Performance and Noise-Reduction Outcomes

by Subong Kim, Susan Arzac, Natalie Dokic, Jenn Donnelly, Nicole Genser, Kristen Nortwich and Alexis Rooney

Audiol. Res. 2025, 15(4), 78; https://doi.org/10.3390/audiolres15040078 - 2 Jul 2025

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Abstract

Background/Objectives: Individuals with similar hearing sensitivity exhibit varying levels of tolerance to background noise, a trait tied to unique individual characteristics that affect their responsiveness to noise reduction (NR) processing in hearing aids. The present study aimed to capture such individual characteristics [...] Read more.

Background/Objectives: Individuals with similar hearing sensitivity exhibit varying levels of tolerance to background noise, a trait tied to unique individual characteristics that affect their responsiveness to noise reduction (NR) processing in hearing aids. The present study aimed to capture such individual characteristics by employing electrophysiological measures and subjective noise-tolerance profiles, and both were analyzed in relation to speech-in-noise performance and NR outcomes. Methods: From a sample of 42 participants with normal hearing, the neural signal-to-noise ratio (SNR)—a cortical index comparing the amplitude ratio between auditory evoked responses to target speech onset versus noise onset—was calculated, and individual noise-tolerance profiles were also derived using k-means cluster analysis to classify participants into distinct subgroups. Results: The neural SNR showed significant correlations with speech-in-noise performance and NR outcomes with varying strength. In contrast, noise-tolerance subgroups did not show meaningful group-level differences in either speech-in-noise or NR outcomes. The neural SNR and noise-tolerance profiles were found to be statistically independent. Conclusions: While the neural SNR reliably predicted perceptual performance in background noise and NR outcomes, our noise-tolerance profiles lacked sufficient sensitivity. Still, subjective ratings of individual noise tolerance are clinically accessible, and thus, integrating both physiology and subjective measures in the same cohort is a valuable strategy. Full article

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27 pages, 3422 KiB

Open AccessArticle

Audiovisual Perception of Sentence Stress in Cochlear Implant Recipients

by Hartmut Meister, Moritz Wächtler, Pascale Sandmann, Ruth Lang-Roth and Khaled H. A. Abdel-Latif

Audiol. Res. 2025, 15(4), 77; https://doi.org/10.3390/audiolres15040077 - 24 Jun 2025

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Abstract

Background/Objectives: Sentence stress as part of linguistic prosody plays an important role for verbal communication. It emphasizes particularly important words in a phrase and is reflected by acoustic cues such as the voice fundamental frequency. However, visual cues, especially facial movements, are also [...] Read more.

Background/Objectives: Sentence stress as part of linguistic prosody plays an important role for verbal communication. It emphasizes particularly important words in a phrase and is reflected by acoustic cues such as the voice fundamental frequency. However, visual cues, especially facial movements, are also important for sentence stress perception. Since cochlear implant (CI) recipients are limited in their use of acoustic prosody cues, the question arises as to what extent they are able to exploit visual features. Methods: Virtual characters were used to provide highly realistic but controllable stimuli for investigating sentence stress in groups of experienced CI recipients and typical-hearing (TH) peers. In addition to the proportion of correctly identified stressed words, task load was assessed via reaction times (RTs) and task-evoked pupil dilation (TEPD), and visual attention was estimated via eye tracking. Experiment 1 considered congruent combinations of auditory and visual cues, while Experiment 2 presented incongruent stimuli. Results: In Experiment 1, CI users and TH participants performed similarly in the congruent audiovisual condition, while the former were better at using visual cues. RTs were generally faster in the AV condition, whereas TEPD revealed a more detailed picture, with TH subjects showing greater pupil dilation in the visual condition. The incongruent stimuli in Experiment 2 showed that modality use varied individually among CI recipients, while TH participants relied primarily on auditory cues. Conclusions: Visual cues are generally useful for perceiving sentence stress. As a group, CI users are better at using facial cues than their TH peers. However, CI users show individual differences in the reliability of the various cues. Full article

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15 pages, 556 KiB

Open AccessArticle

Sleep Assessment in Patients with Inner Ear Functional Disorders: A Prospective Cohort Study Investigating Sleep Quality Through Polygraphy Recordings

by Dorota Kuryga and Artur Niedzielski

Audiol. Res. 2025, 15(4), 76; https://doi.org/10.3390/audiolres15040076 - 24 Jun 2025

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Abstract

Background/Objectives: The vestibulo-respiratory reflex regulates the tension of the respiratory muscles, which prevents apneas and awakenings during sleep. This study aimed to determine whether functional deficits in the inner ear disturb sleep quality. Methods: We compared sleep parameters in patients with their [...] Read more.

Background/Objectives: The vestibulo-respiratory reflex regulates the tension of the respiratory muscles, which prevents apneas and awakenings during sleep. This study aimed to determine whether functional deficits in the inner ear disturb sleep quality. Methods: We compared sleep parameters in patients with their first episode of acute inner ear deficit (Group A: sudden idiopathic vertigo attack, sudden sensorineural hearing loss), chronic functional inner ear impairment (Group B: chronic peripheral vertigo, permanent hearing loss), and in healthy individuals (Group C). Polygraphy recordings were performed twice, in Group A at the onset of acute otoneurological symptoms and the second time after their withdrawal with an interval of 1 to 13 days, in Group B after 1 to 6 days, and in Group C after 1 to 8 days. Results: In Group A during the symptomatic night, overall and central apnea-hypopnea indices were significantly higher and snoring time was longer. Group A also had higher central apnea-hypopnea index on the first night compared to healthy individuals. In chronic disorders, sleep recordings showed lower autonomic arousal index than in controls or symptomatic nights in Group A. Conclusions: These findings highlight the severity of sleep apnea indicators in Group A. Our results suggest that acute dysfunction of the inner ear substantially impacts central neuronal signaling responsible for regulating normal sleep-related breathing and leads to a deterioration in sleep quality in contrast to individuals with chronic inner ear impairments. It can also be assumed that people with chronic vertigo or hearing loss experience less interrupted sleep than healthy individuals. Full article

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19 pages, 748 KiB

Open AccessSystematic Review

Kolliker’s Organ and Its Functional Role in the Development of Corti’s Organ and Auditory Systems

by Valeria Caragli, Valerio M. Di Pasquale Fiasca, Elisabetta Genovese and Alessandro Martini

Audiol. Res. 2025, 15(4), 75; https://doi.org/10.3390/audiolres15040075 - 23 Jun 2025

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Abstract

Background: Kölliker’s organ (KO), a transient structure in the cochlea, plays a critical role in the auditory maturation of mammals, particularly during embryonic and early postnatal development. This organ is essential for the proper differentiation and function of cochlear cells, acting as [...] Read more.

Background: Kölliker’s organ (KO), a transient structure in the cochlea, plays a critical role in the auditory maturation of mammals, particularly during embryonic and early postnatal development. This organ is essential for the proper differentiation and function of cochlear cells, acting as a pivotal source of signalling molecules that influence hair cell development and synaptic connectivity. Methods: This study systematically analyses the literature according to the PRISMA statement in order to evaluate the function roles of KO during cochlea development, reporting the molecular mechanisms and signalling pathways involved. Results: From our study, it emerged that KO supporting cells release adenosine triphosphate (ATP) through connexin hemichannels, initiating a cascade of intracellular calcium (Ca²⁺) signalling in adjacent inner hair cells (IHCs). This signalling promotes the release of glutamate, facilitating synaptic excitation of afferent nerve fibres and enhancing auditory neuron maturation prior to the onset of hearing. Additionally, the spontaneous electrical activity generated within KO supports the establishment of essential neural connections in the auditory pathway. The dynamic interplay between ATP release, Ca²⁺ signalling, and morphological changes in KO is crucial for cochlear compartmentalisation and fluid regulation, contributing to the formation of endolymph and perilymph. Furthermore, KO supports cellular plasticity and may provide a reservoir of precursor cells capable of trans-differentiating into hair cells under specific conditions. Conclusions: Dysregulation of KO function or delayed degeneration of its supporting cells has been implicated in auditory disorders, underscoring the importance of this organ in normal cochlear development and auditory function. Despite its identification over a century ago, further investigation is necessary to elucidate the molecular mechanisms underlying KO’s contributions to auditory maturation, particularly in human physiology. Full article

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Audiol. Res., Volume 15, Issue 4 (August 2025) – 11 articles

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