Audiology Research

13 pages, 872 KB

Open AccessArticle

Diode Laser Stapedotomy: Audiological Results and Clinical Safety

by Daniela Parrino, Guglielmo Romano, Graziano Pavan, Paolo Castelnuovo and Maurizio Bignami

Audiol. Res. 2026, 16(1), 22; https://doi.org/10.3390/audiolres16010022 (registering DOI) - 2 Feb 2026

Background and objectives: Stapedotomy is the surgical treatment for otosclerosis, with excellent results in terms of hearing recovery. Various laser systems have proven to be an interesting alternative to the conventional technique, allowing for a more precise footplate fenestration with apparently less trauma [...] Read more.

Background and objectives: Stapedotomy is the surgical treatment for otosclerosis, with excellent results in terms of hearing recovery. Various laser systems have proven to be an interesting alternative to the conventional technique, allowing for a more precise footplate fenestration with apparently less trauma to the inner ear. The diode laser, more recently introduced, seems to offer more controlled tissue interaction, potentially reducing thermal damage to surrounding structures. However, the literature remains limited. The aim of the present study was to evaluate the functional outcomes and clinical safety of diode laser stapedotomy by comparing the observed results with those previously reported. Materials and methods: A retrospective analysis of 105 patients who underwent diode laser stapedotomy was conducted. The audiological data and the complications were analyzed and compared with a cohort of patients who underwent stapedotomy performed using the conventional technique. Results: In patients who underwent diode laser stapedotomy, the postoperative air–bone gap (ABG) improved significantly at all frequencies. Hearing outcomes were excellent (ABG ≤ 10 dB) in 60.9% of cases, good (ABG ≤ 20 dB) in 89.5%, and poor (ABG > 20 dB) in 10.5% of patients. Intraoperative complications occurred in seven patients (6.7%), including two cases (1.9%) of footplate damage. Postoperatively, 13 cases of vertigo (12.4%), three cases of tinnitus (2.8%), and one case of sensorineural hearing loss (0.9%) were reported. Conclusions: Diode laser stapedotomy is an effective and safe procedure, providing excellent audiological outcomes without increasing the risk of surgical complications. The possibility of thermal damage to the inner ear must be considered, and appropriate laser parameters should be used to minimize these risks. Full article

(This article belongs to the Section Hearing)

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31 pages, 2818 KB

Open AccessReview

Multiscale Integration of Acceleration and Jerk Sensing in the Vestibular System

by Leonardo Manzari

Audiol. Res. 2026, 16(1), 21; https://doi.org/10.3390/audiolres16010021 - 30 Jan 2026

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Abstract

Background: The vestibular system encodes head motion through specialized Type I and Type II hair cells, which differentially respond to acceleration and its temporal derivative, jerk. Molecular gradients of retinoic acid establish zonal distributions of these hair cells, prefiguring their functional specialization. Objectives [...] Read more.

Background: The vestibular system encodes head motion through specialized Type I and Type II hair cells, which differentially respond to acceleration and its temporal derivative, jerk. Molecular gradients of retinoic acid establish zonal distributions of these hair cells, prefiguring their functional specialization. Objectives & Methods: Here I integrate developmental, synaptic, biomechanical, and neural evidence to propose that Type I hair cells, via multimodal synaptic transmission, are particularly well suited for ultrafast detection of transient inertial deformation (jerk), whereas Type II cells play a greater role in encoding sustained acceleration through viscous-flow mechanisms. Molecular gradients of retinoic acid help establish central–peripheral zonal patterning in the otolith and canal epithelia, which in turn underlies differential mechanical and synaptic specialization rather than a simple redistribution of hair-cell types. Computational and experimental studies reveal that the vestibular organs operate in dual mechanical regimes, enabling the dynamic encoding of motion onset and continuity. In systems terms, these viscous and inertial activation modes correspond to distinct temporal filters, whose different time constants naturally give rise to distinct frequency responses. What has traditionally been described as ‘low- vs. high-frequency’ tuning therefore emerges as the frequency-domain signature of acceleration- versus jerk-sensitive pathways. Conclusions: This hierarchical organization elucidates the selective activation observed in clinical vestibular tests and informs novel diagnostic and rehabilitative strategies targeting specific receptor pathways. Together, these findings redefine vestibular transduction as a multimodal dynamic sensor, enhancing our understanding of balance and spatial orientation under complex motion conditions. Full article

(This article belongs to the Section Balance)

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20 pages, 875 KB

Open AccessReview

On the Coexistence of Captions and Sign Language as Accessibility Solutions in Educational Settings

by Francesco Pavani and Valerio Leonetti

Audiol. Res. 2026, 16(1), 20; https://doi.org/10.3390/audiolres16010020 - 29 Jan 2026

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Abstract

Background/Objectives: In mainstream educational settings, deaf and hard-of-hearing (DHH) students may have limited or no access to the spoken lectures and discussions that are central to the hearing majority classroom. Yet, engagement in these educational and social exchanges is fundamental to their learning [...] Read more.

Background/Objectives: In mainstream educational settings, deaf and hard-of-hearing (DHH) students may have limited or no access to the spoken lectures and discussions that are central to the hearing majority classroom. Yet, engagement in these educational and social exchanges is fundamental to their learning and inclusion. Two primary visual accessibility solutions can support this need: real-time speech-to-text transcriptions (i.e., captioning) and high-quality sign language interpreting. Their combined use (or coexistence), however, raises concerns of competition between concurrent streams of visual information. This article examines the empirical evidence concerning the effectiveness of using both captioning and sign language simultaneously in educational settings. Specifically, it investigates whether this combined approach leads to better or worse content learning for DHH students, when compared to using either visual accessibility solution in isolation. Methods: A review of all English language studies in peer-reviewed journals until August 2025 was performed. Eligible studies used an experimental design to compare content learning when using sign language and captions together, versus using sign language or captions on their own. Databases Reviewed: EMBASE, PubMed/MEDLINE, and PsycInfo. Results: A total of four studies met the criteria for inclusion. This limited evidence is insufficient to decide on the coexistence of captioning and sign language. Yet, it underscores the potential of captions for content access in education for DHH, even when sign language is available. Conclusions: The present article reveals the lack of evidence in favor or against its coexistence with sign language. With the aim to be constructive for future research, the discussion offers considerations on the attentional demands of simultaneous visual accessibility resources, the diversity of DHH learners, and the impact of current and forthcoming technological advancements. Full article

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

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13 pages, 5628 KB

Open AccessArticle

Trends in Adult Cochlear Implant Access and Uptake Across Ten Years of Reported Data

by Patrick D’Haese, Paul Van de Heyning, Javier Gavilan, Mario Emilio Zernotti and Paula Greenham

Audiol. Res. 2026, 16(1), 19; https://doi.org/10.3390/audiolres16010019 - 29 Jan 2026

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Abstract

Background: Adults with severe to profound hearing loss have limited access to cochlear implants (CIs). The objective of this study was to assess the evidence to establish whether the uptake rate of CIs has changed over the past decade. Methods: A PubMed search, [...] Read more.

Background: Adults with severe to profound hearing loss have limited access to cochlear implants (CIs). The objective of this study was to assess the evidence to establish whether the uptake rate of CIs has changed over the past decade. Methods: A PubMed search, supplemented with manual searching, identified 15 relevant papers published from 2000 to 4 February 2025 reporting the uptake rate of CIs in adults. In addition, new calculations of uptake rates were made for 2019, based on total numbers of CIs implanted and the prevalence of hearing loss from the 2019 Global Burden of Disease Study. Results: There was a lack of published data on the uptake rates for cochlear implants, with very little consensus in the methods used across studies. The overall uptake rates for adults and children combined, calculated for 2019 using the Lancet Global Burden of Disease Study, showed that uptake is still ≤20% for those with profound to complete hearing loss in most high-income countries. When the global population is considered (including high- to low-income countries), it is merely 2.5%. Conclusions: Despite the cochlear implant awareness activities of recent years, the percentage of profoundly deaf individuals with cochlear implants, even in high-income countries, remains low. Uptake rates are much worse than those for hearing aid use for severe to profound deafness. Better and more accurate data must be gathered on the number of CI recipients to meet the reporting requirements of the World Health Organisation’s report on hearing. Full article

(This article belongs to the Section Hearing)

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24 pages, 350 KB

Open AccessArticle

Home Language Activities and Language Ability Between Chinese Preschool Children with Cochlear Implants and Children with Normal Hearing

by Meilin He and Inho Chung

Audiol. Res. 2026, 16(1), 18; https://doi.org/10.3390/audiolres16010018 - 28 Jan 2026

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Abstract

This study explored the relationship between different home language activities and language ability in Chinese preschoolers with cochlear implants (CIs) (mean age = 4.50, range = 3–5), comparing them with normally hearing (NH) peers (mean age = 4.66, range = 3–5). Correlation and [...] Read more.

This study explored the relationship between different home language activities and language ability in Chinese preschoolers with cochlear implants (CIs) (mean age = 4.50, range = 3–5), comparing them with normally hearing (NH) peers (mean age = 4.66, range = 3–5). Correlation and regression analyses revealed distinct predictive patterns between the two groups. In the CI group, although family literacy activities such as shared reading were associated with language skills, daily communication activities (e.g., conversational interactions) had a more significant predictive effect on language outcomes, even after controlling for key demographic variables. Conversely, for NH preschool children, family literacy activities showed a clearer independent association with language development. This study offers clearer insights for home-based rehabilitation practices among CI preschool children, suggesting that interventions should prioritize high-quality daily communication (e.g., open-ended questioning, extended dialog, contextualized interactions) rather than over-reliance on structured literacy activities. It also indicates that intervention models designed for NH preschool children cannot be simply applied. Full article

(This article belongs to the Section Speech and Language)

13 pages, 2805 KB

Open AccessArticle

Hemispheric Asymmetry in Cortical Auditory Processing: The Interactive Effects of Attention and Background Noise

by Anoop Basavanahalli Jagadeesh and Ajith Kumar Uppunda

Audiol. Res. 2026, 16(1), 17; https://doi.org/10.3390/audiolres16010017 - 28 Jan 2026

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Abstract

Background/Objectives: Speech processing engages both hemispheres of the brain but exhibits a degree of hemispheric asymmetry. This asymmetry, however, is not fixed and can be shaped by stimulus-related and listener-related factors. The present study examined how background noise and attention influence hemispheric [...] Read more.

Background/Objectives: Speech processing engages both hemispheres of the brain but exhibits a degree of hemispheric asymmetry. This asymmetry, however, is not fixed and can be shaped by stimulus-related and listener-related factors. The present study examined how background noise and attention influence hemispheric differences in speech processing using high-density cortical auditory evoked potentials (CAEPs). Methods: Twenty-five young adults with clinically normal hearing listened to meaningful bisyllabic Kannada words under two background conditions (quiet, speech-shaped noise) and two attentional conditions (active, passive). N1 peak amplitudes were compared between the left and right hemispheres across conditions using linear mixed-effects modeling. Results: Results revealed significantly larger N1 amplitudes in the left hemisphere and during active compared to passive listening, confirming left-hemisphere dominance for speech processing and robust attentional modulation. In contrast, background noise did not significantly modulate N1 amplitude or hemispheric asymmetry. Importantly, a significant Hemisphere × Attention interaction indicated that hemispheric asymmetry depended on attentional state, with clear left-hemisphere dominance being observed during active listening in both quiet and noise conditions, whereas hemispheric differences were reduced or absent during passive listening, irrespective of background. Conclusions: Together, these findings demonstrate that attentional engagement, rather than background noise, plays a critical role in modulating hemispheric specialization during early cortical speech processing, highlighting the adaptive nature of auditory cortical mechanisms in challenging listening environments. Full article

(This article belongs to the Section Hearing)

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11 pages, 1506 KB

Open AccessTechnical Note

Development of a Speech Intelligibility Test for Children in Swiss German Dialects

by Christoph Schmid, Stefanie Blatter, Eberhard Seifert, Philipp Aebischer and Martin Kompis

Audiol. Res. 2026, 16(1), 16; https://doi.org/10.3390/audiolres16010016 - 22 Jan 2026

Viewed by 102

Abstract

Objective: This paper describes the development of a speech intelligibility test in Swiss German dialects, designed for children aged four to nine who are not yet familiar with standard German. Method: Suitable monosyllabic words and trochees in different Swiss German dialects were compiled, [...] Read more.

Objective: This paper describes the development of a speech intelligibility test in Swiss German dialects, designed for children aged four to nine who are not yet familiar with standard German. Method: Suitable monosyllabic words and trochees in different Swiss German dialects were compiled, illustrated, and evaluated. Picture-pointing test procedures appropriate for children were developed. The selected test words and the pictures representing them were evaluated in a preliminary trial with forty-six normal-hearing children between two and nine years of age. Results: A set of 60 monosyllabic words and 40 trochees was recorded in four different Swiss German dialects as well as in standard German, resulting in a total of 500 recordings. Drawings were created to illustrate each word and found to be appropriate for children aged four years old or older. A non-adaptive and an adaptive test procedure using a weighted up–down method to measure speech reception thresholds in quiet and in noise were developed. Conclusions: A novel test to determine speech intelligibility in children in four different Swiss dialects was developed and evaluated in a pilot study. A validation study with more participants was designed to evaluate the test material and procedures. Full article

(This article belongs to the Section Speech and Language)

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18 pages, 748 KB

Open AccessArticle

Endolymphatic Sac Surgery in Refractory Ménière’s Disease: Exploratory Associations and Postoperative Clinical Outcomes in a Bicentric Cohort

by Eleonore Lebelle, Maria-Pia Tuset, Ralph Haddad, Dario Ebode, Daniel Levy, Laetitia Ros, Quentin Mat, Mary Daval, Justin Michel, Laure De Charnace and Stéphane Gargula

Audiol. Res. 2026, 16(1), 15; https://doi.org/10.3390/audiolres16010015 - 20 Jan 2026

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Abstract

Background/Objectives: Endolymphatic sac surgery (ELSS) is a non-destructive surgical option for medically refractory Ménière’s disease (MD), yet factors influencing surgical outcomes remain poorly understood. This exploratory study aimed to describe clinical outcomes following ELSS and identify potential associations between preoperative characteristics and [...] Read more.

Background/Objectives: Endolymphatic sac surgery (ELSS) is a non-destructive surgical option for medically refractory Ménière’s disease (MD), yet factors influencing surgical outcomes remain poorly understood. This exploratory study aimed to describe clinical outcomes following ELSS and identify potential associations between preoperative characteristics and surgical success. Methods: This retrospective, bicentric cohort study included 45 patients with definite MD who underwent ELSS (predominantly endolymphatic duct blockage) between 2019 and 2024. Vertigo control was assessed using AAO-HNS criteria. Hearing outcomes were evaluated through pure-tone and speech audiometry. Univariate analyses explored associations between demographic, clinical, imaging, and surgical variables and treatment outcomes. Results: Surgical success (Class A/B vertigo control) was achieved in 66.7% of patients (95% CI: 51.0–80.0%). In a post hoc exploratory analysis, longer disease duration (>5 years) showed an association with better outcomes (87.5% vs. 55.2%, p = 0.029), though this threshold was not prespecified and requires validation. Hearing was preserved in 77.5% of patients at 45-day follow-up but declined progressively to 50% at 2 years. Seven patients developed postoperative Tumarkin attacks, with five requiring non-conservative interventions. ELSS demonstrated low morbidity, with one labyrinthitis as the only significant complication. Conclusions: ELSS was associated with vertigo control in two-thirds of patients with refractory MD, with a favorable safety profile. Longer disease duration before surgery may be associated with improved outcomes, though this exploratory finding requires confirmation in prospective studies. The progressive hearing decline may reflect both natural disease progression and potential surgical effects. Further research with larger cohorts is needed to establish robust predictive criteria for patient selection. Full article

(This article belongs to the Section Balance)

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12 pages, 2133 KB

Open AccessArticle

Maternal and Neonatal Vulnerabilities Associated with Abnormal Outcomes in Newborn Hearing Screening: A Focus on Adolescent Mothers

by Mirela Mătăsaru, Elena Niculet, Emil Anton, Ancuța Lupu, Oana Ramona Roșca, Doina Carina Voinescu, Mădălina Nicoleta Matei, Alina Pleșea-Condratovici, Camer Salim and Silvia Fotea

Audiol. Res. 2026, 16(1), 14; https://doi.org/10.3390/audiolres16010014 - 20 Jan 2026

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Abstract

Universal newborn hearing screening is essential for early identification of sensorineural hearing loss. Infants born to adolescent mothers may be more vulnerable to abnormal screening outcomes due to biological, socio-economic, and obstetrical risk factors frequently associated with adolescent pregnancy. This study evaluates hearing [...] Read more.

Universal newborn hearing screening is essential for early identification of sensorineural hearing loss. Infants born to adolescent mothers may be more vulnerable to abnormal screening outcomes due to biological, socio-economic, and obstetrical risk factors frequently associated with adolescent pregnancy. This study evaluates hearing screening outcomes in newborns of adolescent mothers and examines whether maternal and neonatal vulnerabilities contribute to abnormal (REFER) results. A retrospective observational study was conducted over four years (January 2021–January 2025) at the “Sf. Ap. Andrei” County Emergency Clinical Hospital, Galați, Romania. The study included 187 newborns of adolescent mothers (≤18 years) and 3203 newborns of mothers aged >19 years. All infants underwent transient evoked otoacoustic emission (TEOAE) testing within 48–72 h after birth, according to institutional protocol. PASS/REFER outcomes were recorded, and retesting was performed when indicated. Although otological conditions such as middle ear dysfunction may influence OAE responses, routine otoscopic examination and clinical assessment were performed prior to testing. Automated auditory brainstem response (AABR) testing was not routinely applied due to equipment availability and local screening practices. The final REFER rate was slightly higher in the adolescent group (5.3%) compared with the adult group (4.8%). Maternal age alone was not directly associated with abnormal outcomes; however, maternal anemia, limited prenatal care, rural residence, prematurity, and low birth weight were more frequently observed among cases with persistent REFER results. Infants born to adolescent mothers show a modestly increased likelihood of abnormal hearing screening outcomes, primarily related to cumulative maternal and neonatal vulnerabilities. Strengthening prenatal care and targeted audiological follow-up may improve early detection of sensorineural hearing loss in this population. Full article

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8 pages, 718 KB

Open AccessArticle

Emotional and Cognitive Effects of Simulated Temporary Hearing Deficit with Healthy Adults

by Leora Moss Levy and Kinneret Weisler

Audiol. Res. 2026, 16(1), 13; https://doi.org/10.3390/audiolres16010013 - 19 Jan 2026

Viewed by 146

Abstract

Background/Objectives: Accumulation of cerumen (earwax) in the auditory canal is a common condition, particularly in children and older adults, and often causes temporary hearing loss. While chronic hearing loss is known to affect mood and cognition, little is known about the psychological [...] Read more.

Background/Objectives: Accumulation of cerumen (earwax) in the auditory canal is a common condition, particularly in children and older adults, and often causes temporary hearing loss. While chronic hearing loss is known to affect mood and cognition, little is known about the psychological impact of short-term auditory deprivation. This pilot study aimed to examine the emotional and cognitive effects of simulated temporary hearing loss. Methods: Thirty healthy adults (16 females, aged 18–60) participated. Temporary hearing loss was simulated by placing earplugs in both ears for two hours. Participants completed four tests, assessing anxiety, mood, and attention at three time points: before wearing earplugs, during the blocked condition, and after earplug removal. Results: Participants showed a significant increase in state anxiety and a decrease in mood during the earplug condition. Interestingly, visual attention performance improved while hearing was obstructed and remained elevated even after earplug removal. Conclusions: Short-term simulated hearing loss produces measurable emotional and cognitive changes, including increased anxiety but enhanced visual attention. Clinicians should consider these effects when assessing patients with temporary hearing obstruction, such as those with cerumen impaction. The results carry implications for the broader population wearing earplugs on a temporary basis including musicians, construction employees, and, in general, people working in noisy environments. Full article

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16 pages, 1051 KB

Open AccessArticle

Exploring the Effects of Attribute Framing and Popularity Cueing on Hearing Aid Purchase Likelihood

by Craig Richard St. Jean, Jacqueline Cummine, Gurjit Singh and William (Bill) Hodgetts

Audiol. Res. 2026, 16(1), 12; https://doi.org/10.3390/audiolres16010012 - 17 Jan 2026

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Abstract

Background/Objectives: This study explored how attribute framing (lifestyle-focused vs. technology-focused product descriptions) and popularity cueing (presence or absence of a “best-seller” label) influenced purchase likelihood for a fictitious selection of hearing aids (HAs) among Canadian adults aged 40 years and above. The study [...] Read more.

Background/Objectives: This study explored how attribute framing (lifestyle-focused vs. technology-focused product descriptions) and popularity cueing (presence or absence of a “best-seller” label) influenced purchase likelihood for a fictitious selection of hearing aids (HAs) among Canadian adults aged 40 years and above. The study further aimed to investigate whether the effects observed were unique to HAs or applicable to less-specialized consumer technology contexts. Method: A 2 × 2 × 2 mixed experimental design compared attribute framing and popularity cueing effects across HAs and notebook computers at three technology levels (entry-level, midrange, and premium). Participants (n = 122) provided ratings indicating their purchase likelihood for each product. Results: Attribute framing showed no significant influence on purchase decisions across technology levels. The presence of a popularity cue that the midrange HA was the best-seller negatively affected purchase likelihood for the entry-level HA, with higher purchase likelihood ratings observed when this cue was absent. Participants expressed stronger purchase likelihood for premium HAs compared to premium notebook computers. Notably, these two effects were not statistically significant following correction for multiple comparisons. Conclusions: Popularity cues for HAs may have inadvertent consequences for consumer perceptions of models with differing technology levels. Findings also suggest potentially greater willingness to invest in premium health-related technologies versus familiar consumer technology. Further research involving current HA users or candidates is needed to better understand these findings. Full article

(This article belongs to the Section Hearing)

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16 pages, 602 KB

Open AccessSystematic Review

Vestibular Evoked Myogenic Potential in Vestibular Migraine: A Systematic Review of Diagnostic Utility

by Mayur Bhat, Krithi Rao, Sinchana Hegde, Kaushlendra Kumar, Aditya Khandagale, KM Prajwal and Shezeen Abdul Gafoor

Audiol. Res. 2026, 16(1), 11; https://doi.org/10.3390/audiolres16010011 - 17 Jan 2026

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Abstract

Background/Objectives: Vestibular migraine (VM) is one of the most prevalent causes of episodic vertigo, yet it remains underdiagnosed due to overlapping features with other vestibular disorders and the absence of definitive diagnostic tests. Vestibular evoked myogenic potentials (VEMPs) assess otolith and vestibular nerve [...] Read more.

Background/Objectives: Vestibular migraine (VM) is one of the most prevalent causes of episodic vertigo, yet it remains underdiagnosed due to overlapping features with other vestibular disorders and the absence of definitive diagnostic tests. Vestibular evoked myogenic potentials (VEMPs) assess otolith and vestibular nerve function and may help identify pathophysiological mechanisms in VM. This systematic review aimed to evaluate the usefulness of VEMP in understanding VM, synthesize existing findings, and explore its clinical implications. Method: A systematic search was performed in PubMed, ProQuest, Scopus, Web of Science, and EMBASE up to 2025 following PRISMA guidelines. Studies were included if they assessed cVEMP and/or oVEMP in patients diagnosed with VM using established clinical criteria. Data extraction and quality assessment were conducted independently by three reviewers using Cochrane and Joanna Briggs Institute tools. A total of 2578 titles and abstracts were screened, and 28 studies met the inclusion criteria. Results: Across 28 studies, 23 reported VEMP abnormalities in VM. The most frequent findings were reduced amplitudes and increased asymmetry ratios compared to healthy controls, indicating potential otolithic dysfunction. Latency prolongations were less consistently reported. Differences between cVEMP and oVEMP findings in individuals with VM suggested variable involvement of saccular and utricular pathways, with oVEMP abnormalities appearing more prominent. Conclusions: VEMP testing reveals subtle vestibular dysfunction in VM, primarily reflected in reduced amplitude and altered asymmetry ratios. However, the association between VEMP abnormality and VM is inconclusive, specifically due to heterogeneity among the included studies. Although findings support its potential as a diagnostic adjunct, methodological variability (including variability in patient recruitment) underscores the need for standardized VEMP protocols to enhance diagnostic accuracy and comparability across studies. Full article

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Graphical abstract

13 pages, 252 KB

Open AccessArticle

Vestibular Function in Long-Term Hearing Aid Users: A Preliminary Investigation

by M. Ramiz Malik, Kaushlendra Kumar, Mohan Kumar Kalaiah, Niraj Kumar Singh and Mayur Bhat

Audiol. Res. 2026, 16(1), 10; https://doi.org/10.3390/audiolres16010010 - 15 Jan 2026

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Abstract

Background/Objectives: This study compared vestibular evoked myogenic potentials (VEMP) and video head impulse test (vHIT) findings between long-term hearing aid users and non-users with moderately severe to profound sensorineural hearing loss (SNHL) to investigate whether prolonged use of high-power hearing aids has any [...] Read more.

Background/Objectives: This study compared vestibular evoked myogenic potentials (VEMP) and video head impulse test (vHIT) findings between long-term hearing aid users and non-users with moderately severe to profound sensorineural hearing loss (SNHL) to investigate whether prolonged use of high-power hearing aids has any effect on the functioning of peripheral vestibular organs. Methods: A cross-sectional study was conducted in the audiology clinic of a tertiary care hospital. Using convenience sampling, 67 adults aged 20–64 years who visited for hearing evaluation or hearing aid services were recruited and allocated into hearing aid user and non-user groups. VEMP latency and amplitude and vHIT vestibulo-ocular reflex (VOR) gain values were compared between groups. Multiple linear regression was performed to examine the association between the duration of hearing aid use and vestibular function. Results: No significant group differences were observed for any VEMP or vHIT parameter, except for the latency of P1 of the cVEMP in the left ear. Regression analyses indicated that the duration of hearing aid use was not significantly associated with any vestibular test measure. Conclusions: Long-term use of high-power hearing aids does not appear to be associated with measurable alterations in vestibular function. Nonetheless, longitudinal studies with improved control of confounding variables are recommended to validate these preliminary findings. Full article

16 pages, 282 KB

Open AccessReview

Dysphagia and Dysarthria in Neurodegenerative Diseases: A Multisystem Network Approach to Assessment and Management

by Maria Luisa Fiorella, Luca Ballini, Valentina Lavermicocca, Maria Sterpeta Ragno, Domenico A. Restivo and Rosario Marchese-Ragona

Audiol. Res. 2026, 16(1), 9; https://doi.org/10.3390/audiolres16010009 - 12 Jan 2026

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Abstract

Dysphagia and dysarthria are common, co-occurring manifestations in neurodegenerative diseases, resulting from damage to distributed neural networks involving cortical, subcortical, cerebellar, and brainstem regions. These disorders profoundly affect patient health and quality of life through complex sensorimotor impairments. Objective: The aims was [...] Read more.

Dysphagia and dysarthria are common, co-occurring manifestations in neurodegenerative diseases, resulting from damage to distributed neural networks involving cortical, subcortical, cerebellar, and brainstem regions. These disorders profoundly affect patient health and quality of life through complex sensorimotor impairments. Objective: The aims was to provide a comprehensive, evidence-based review of the neuroanatomical substrates, pathophysiology, diagnostic approaches, and management strategies for dysphagia and dysarthria in neurodegenerative diseases with emphasis on their multisystem nature and integrated treatment approaches. Methods: A narrative literature review was conducted using PubMed, Scopus, and Web of Science databases (2000–2024), focusing on Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA). Search terms included “dysphagia”, “dysarthria”, “neurodegenerative diseases”, “neural networks”, “swallowing control” and “speech production.” Studies on neuroanatomy, pathophysiology, diagnostic tools, and therapeutic interventions were included. Results: Contemporary neuroscience demonstrates that swallowing and speech control involve extensive neural networks beyond the brainstem, including bilateral sensorimotor cortex, insula, cingulate gyrus, basal ganglia, and cerebellum. Disease-specific patterns reflect multisystem involvement: PD affects basal ganglia and multiple brainstem nuclei; ALS involves cortical and brainstem motor neurons; MSA causes widespread autonomic and motor degeneration; PSP produces tau-related damage across multiple brain regions. Diagnostic approaches combining fiberoptic endoscopic evaluation, videofluoroscopy, acoustic analysis, and neuroimaging enable precise characterization. Management requires multidisciplinary Integrated teams implementing coordinated speech-swallowing therapy, pharmacological interventions, and assistive technologies. Conclusions: Dysphagia and dysarthria in neurodegenerative diseases result from multifocal brain damage affecting distributed neural networks. Understanding this multisystem pathophysiology enables more effective integrated assessment and treatment approaches, enhancing patient outcomes and quality of life. Full article

(This article belongs to the Special Issue Impact of Brainstem Diseases on Hearing, Balance, Speech and Swallowing)

11 pages, 2443 KB

Open AccessArticle

Lying Down Nystagmus in Lateral Canal Paroxysmal Positional Vertigo

by Mauro Gufoni, Nicola Ducci, Davide Bernacca, Luigi Califano and Augusto Pietro Casani

Audiol. Res. 2026, 16(1), 8; https://doi.org/10.3390/audiolres16010008 - 8 Jan 2026

Viewed by 229

Abstract

Introduction: The aim of this study was to determine the position of otoconial debris in lateral ampullar or non-ampullar canalolithiasis, based on two parameters: (1) the direction of the nystagmus appearing when the patient lies down, if present, and (2) the positional [...] Read more.

Introduction: The aim of this study was to determine the position of otoconial debris in lateral ampullar or non-ampullar canalolithiasis, based on two parameters: (1) the direction of the nystagmus appearing when the patient lies down, if present, and (2) the positional nystagmus evoked by the supine roll test. Methods: Theoretical results were compared with a population of 170 patients observed over the past ten years for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The series included 141 geotropic and 29 apogeotropic cases. Results: Among the geotropic forms, 80 showed no supine nystagmus (Geotropic Nystagmus with no supine nystagmus, GT0) (56.7%), 51 had supine nystagmus directed toward the healthy side (Geotropic Nystagmus with supine nystagmus congruent, direct toward the healthy side, GT+) (36.2%), and 10 toward the affected side (Geotropic Nystagmus with supine nystagmus incongruent direct to the affected side, GT−) (7.1%). In the apogeotropic group, 10 showed no supine nystagmus (Apogeotropic nystagmus with no supine nystagmus, AGT0) (34.6%), 16 had nystagmus toward the affected side (Apogeotropic Nystagmus with supine nystagmus congruent, direct toward the affected side, AGT+) (55.2%), and 1 toward the healthy side (Apogeotropic Nystagmus with supine nystagmus Incongruent, direct toward the healthy side, AGT−) (3.4%). Two cases presented monopositional apogeotropic nystagmus (mAGT), consistent with a “sieve-type canal jam” (6.8%). Overall, 90 out of 170 patients (52.9%) showed no nystagmus in the supine position, with a statistically significant difference between variants (p = 0.0474, Yates correction). Conclusions: The comparison between lying-down nystagmus and positional nystagmus, assessed through the Supine Roll Test as the leading diagnostic maneuver for horizontal canal involvement, may help identify the initial location of debris within the lateral semicircular canal and guide the appropriate liberatory maneuver, while the effectiveness and side of the maneuver allow the distinction between canal-side and utricular-side jams. Full article

(This article belongs to the Special Issue A Tribute to John M. Epley)

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12 pages, 233 KB

Open AccessArticle

Video Head Impulse Test: A Prognostic Marker for Patients with Idiopathic Sudden Sensorineural Hearing Loss

by Gaelle Ngankam Fotsing Epse Vofo, Matityahou Ormianer, Marrigje Aagje de Jong, Julia Meyler, Yaakov Noble, Ron Eliashar and Menachem Gross

Audiol. Res. 2026, 16(1), 7; https://doi.org/10.3390/audiolres16010007 - 31 Dec 2025

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Abstract

Background/Objectives: Patients with Idiopathic sudden sensorineural hearing loss (ISSNHL) are often devastated by the unknown etiology coupled with the unknown pathway to recovery. The aim of this study was to evaluate whether abnormalities on the video Head Impulse Test (vHIT) performed early [...] Read more.

Background/Objectives: Patients with Idiopathic sudden sensorineural hearing loss (ISSNHL) are often devastated by the unknown etiology coupled with the unknown pathway to recovery. The aim of this study was to evaluate whether abnormalities on the video Head Impulse Test (vHIT) performed early in the course of ISSNHL are associated with poorer hearing recovery. Methods: Forty-four patients with ISSNHL were prospectively enrolled between 2019 and 2022 following exclusion of differential diagnoses on clinical and MRI evaluation. vHIT was performed within 1–14 days of symptom onset and within 48 h of hospitalization. Recovery at six months was assessed both as a dichotomous outcome and by change in pure tone average (PTA). Group differences were analyzed using Fisher’s exact and Mann–Whitney U tests. A two-predictor logistic regression model examined the association between vHIT results, dizziness, and recovery. Results: Twelve patients exhibited abnormal vHIT findings. Abnormal vHIT was strongly associated with the presence of dizziness and with markedly poorer hearing recovery at six months. Patients with normal vHIT demonstrated substantially greater improvement in PTA thresholds compared with those showing abnormal results. Logistic regression further confirmed that abnormal vHIT was an independent predictor of reduced likelihood of hearing recovery, whereas dizziness alone did not independently influence outcomes. Conclusions: Our findings suggest that abnormal vHIT results in ISSNHL patients are linked to poor hearing recovery, which can enhance patient counseling regarding expectations. Although promising as a prognostic tool, we acknowledge our limited sample size and recommend validation in larger prospective cohorts. Full article

(This article belongs to the Special Issue Emerging Technologies in Audiology: Advancing Assessment, Intervention, and Accessibility)

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10 pages, 500 KB

Open AccessOpinion

Questioning the Usefulness of Stimulation Rate Changes to Optimize Perception in Cochlear Implant Users

by Andreanne Sharp, Daniel Beaudoin, Julie Dufour, Benoit-Antoine Bacon and François Champoux

Audiol. Res. 2026, 16(1), 6; https://doi.org/10.3390/audiolres16010006 - 24 Dec 2025

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Abstract

Research exploring the impact of stimulation rate modifications on perception in cochlear implant users continues to expand. The existing body of research remains contradictory, making it difficult to establish a clear consensus that could inform clinical recommendations. In this context, this article aims [...] Read more.

Research exploring the impact of stimulation rate modifications on perception in cochlear implant users continues to expand. The existing body of research remains contradictory, making it difficult to establish a clear consensus that could inform clinical recommendations. In this context, this article aims to question the usefulness of such adjustments as a clinical intervention beyond the initial fitting, particularly for optimizing non-speech processing. To do so, we combined an overview of the existing literature on the effects of stimulation-rate changes on speech and non-speech processing with a discussion of observational data. The current evidence base is sparse, often contradictory, and affected by interoperability challenges that limit cross-study comparability. Consequently, it is not possible to formulate robust, evidence-based clinical recommendations at this time. Clinicians should be cautious about implementing stimulation-rate adjustments beyond the initial fitting and should wait for more robust evidence to emerge before considering such changes. Full article

(This article belongs to the Collection Cochlear Implants: Challenges and Opportunities in Hearing Rehabilitation)

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34 pages, 761 KB

Open AccessReview

Retrocochlear Auditory Dysfunctions (RADs) and Their Treatment: A Narrative Review

by Domenico Cuda, Patrizia Mancini, Giuseppe Chiarella and Rosamaria Santarelli

Audiol. Res. 2026, 16(1), 5; https://doi.org/10.3390/audiolres16010005 - 23 Dec 2025

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Abstract

Background/Objectives: Retrocochlear auditory dysfunctions (RADs), including auditory neuropathy (AN) and auditory processing disorders (APD), encompass disorders characterized by impaired auditory processing beyond the cochlea. This narrative review critically examines their distinguishing features, synthesizing recent advances in classification, pathophysiology, clinical presentation, and treatment. [...] Read more.

Background/Objectives: Retrocochlear auditory dysfunctions (RADs), including auditory neuropathy (AN) and auditory processing disorders (APD), encompass disorders characterized by impaired auditory processing beyond the cochlea. This narrative review critically examines their distinguishing features, synthesizing recent advances in classification, pathophysiology, clinical presentation, and treatment. Methods: This narrative review involved a comprehensive literature search across major electronic databases (e.g., PubMed, Scopus) to identify and synthesize relevant studies on the classification, diagnosis, and management of AN and APD. The goal was to update the view on etiologies (genetic/non-genetic) and individualized rehabilitative strategies. Diagnosis relies on a comprehensive assessment, including behavioral, electrophysiological, and imaging tests. Rehabilitation is categorized into bottom-up and top-down approaches. Results: ANSD is defined by neural desynchronization with preserved outer hair cell function, resulting in abnormal auditory brainstem responses and poor speech discrimination. The etiologies (distal/proximal) influence the prognosis for interventions, particularly cochlear implants (CI). APD involves central processing deficits, often with normal peripheral hearing and heterogeneous symptoms affecting speech perception and localization. Rehabilitation is multidisciplinary, utilizing bottom-up strategies (e.g., auditory training, CI) and compensatory top-down approaches. Remote microphone systems are highly effective in improving the signal-to-noise ratio. Conclusions: Accurate diagnosis and personalized, multidisciplinary management are crucial for optimizing communication and quality of life. Evidence suggests that combined bottom-up and top-down interventions may yield superior outcomes. However, methodological heterogeneity limits the generalizability of protocols, highlighting the need for further targeted research. Full article

(This article belongs to the Special Issue Impact of Brainstem Diseases on Hearing, Balance, Speech and Swallowing)

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6 pages, 670 KB

Open AccessCase Report

Positional Vertigo in a Child with Hearing Loss

by Melissa Blanco-Pareja, Alberto Vieco García, Teresa Perucho, Javier Santos, José Manuel Moreno-Villares and Nicolas Pérez-Fernández

Audiol. Res. 2026, 16(1), 4; https://doi.org/10.3390/audiolres16010004 - 23 Dec 2025

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Abstract

Background and Clinical Significance: Vestibular disorders in children are often overlooked, delaying treatment. Early diagnosis of benign paroxysmal positional vertigo (BPPV) allows for targeted maneuvers during acute episodes. Though rare, BPPV can occur in children due to stereocilin gene (STRC) [...] Read more.

Background and Clinical Significance: Vestibular disorders in children are often overlooked, delaying treatment. Early diagnosis of benign paroxysmal positional vertigo (BPPV) allows for targeted maneuvers during acute episodes. Though rare, BPPV can occur in children due to stereocilin gene (STRC) deletions or variants, causing hearing loss and vestibular dysfunction. Case Presentation: This study highlights a case of recurrent vertigo linked to a homozygous deletion on chromosome 15 affecting the STRC gene. Full article

(This article belongs to the Section Balance)

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15 pages, 336 KB

Open AccessSystematic Review

Functional Near-Infrared Spectroscopy (fNIRS) in Objective Audiometry: A Scoping Review and Clinical Perspectives

by Tomáš Mimra, Martin Augustynek, Marek Penhaker and Lukáš Klein

Audiol. Res. 2026, 16(1), 3; https://doi.org/10.3390/audiolres16010003 - 19 Dec 2025

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Abstract

Background: The objective assessment of hearing in non-cooperative populations, such as neonates, remains a challenge. While Brainstem Evoked Response Audiometry (BERA) is the gold standard, its sensitivity to motion artifacts necessitates alternatives. Objective: This scoping review maps the current literature on functional near-infrared [...] Read more.

Background: The objective assessment of hearing in non-cooperative populations, such as neonates, remains a challenge. While Brainstem Evoked Response Audiometry (BERA) is the gold standard, its sensitivity to motion artifacts necessitates alternatives. Objective: This scoping review maps the current literature on functional near-infrared spectroscopy (fNIRS) as a supplementary method in objective audiometry. Data Synthesis: fNIRS shows potential to detect cortical hemodynamic responses, particularly to complex stimuli like speech, which BERA cannot fully assess. Key advantages include motion tolerance and suitability for pediatric and cochlear implant populations. However, the literature reveals significant heterogeneity in stimulation protocols and data processing. Evidence suggests fNIRS is better suited for assessing higher-level auditory processing rather than replacing BERA for threshold estimation. Conclusions: fNIRS is a promising complementary tool. However, due to the lack of standardized protocols and large-scale validation studies, it is not yet a direct clinical replacement for BERA. Future work must focus on protocol standardization and establishing robust normative data. Full article

(This article belongs to the Section Hearing)

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14 pages, 406 KB

Open AccessArticle

Translation and Validation of the Portuguese Version of European School for Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ-PT)

by Haúla F. Haider, Ana Solange Fernandes, Ana Filipa Aguiar, Beatriz Oliveira, Iris Peixoto, Marília Antunes, Derek James Hoare and Helena Caria

Audiol. Res. 2026, 16(1), 2; https://doi.org/10.3390/audiolres16010002 - 19 Dec 2025

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Abstract

Objective: Several questionnaires for the diagnosis and characterization of tinnitus are available in English but there is a need for Portuguese standardized questionnaires for use in research and in clinic. The goals of this study were to translate and culturally adapt the ESIT-SQ [...] Read more.

Objective: Several questionnaires for the diagnosis and characterization of tinnitus are available in English but there is a need for Portuguese standardized questionnaires for use in research and in clinic. The goals of this study were to translate and culturally adapt the ESIT-SQ (European School for Interdisciplinary Tinnitus Research Screening Questionnaire) to Portuguese, and to validate the questionnaire for clinical use. Methods: Translation and cross-cultural adaptation of the instrument were performed. The translation stage included the translation and retroversion of the instrument in the languages of interest (English–Portuguese) by three bilingual translators. Subsequently, cross-cultural adaptation was performed involving an Experts Panel (n = 5) and a Patient Panel (n = 4) to evaluate the questionnaire versions obtained after translation and retroversion. Participants completed their evaluation in Microsoft Forms. All ambiguities and uncertainties were addressed by the research team. Validation of the questionnaire involved an ENT specialist (n = 1), health researchers (n = 3), and patients (n = 300). Results: The Portuguese version of the ESIT-SQ (ESIT-SQ-PT) was found to be culturally appropriate, clear, and valid for clinical use. Expert review confirmed strong face validity, with only minor textual adjustments needed. The validation study, involving both online and paper responses, demonstrated good reproducibility and internal consistency across diverse participant profiles. The questionnaire effectively captured a wide range of tinnitus characteristics and associated factors, and reliability analyses confirmed its temporal stability. Overall, the ESIT-SQ-PT proved to be a robust and reliable instrument for assessing tinnitus in Portuguese-speaking populations. Conclusion: The ESIT-SQ in Portuguese (ESIT-SQ-PT), had good face validity, was comprehensible, and was culturally appropriate; thus, it is a valid tool for the screening and assessment of tinnitus and associated symptoms in Portuguese populations. Full article

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16 pages, 571 KB

Open AccessSystematic Review

The Use of vHIT in the Differential Diagnosis Between Vestibular Migraine and Meniere’s Disease: A Systematic Review and Meta-Analysis

by Christos Tsilivigkos, Riccardo Di Micco, Evangelos N. Vitkos and Athanasia Warnecke

Audiol. Res. 2026, 16(1), 1; https://doi.org/10.3390/audiolres16010001 - 19 Dec 2025

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Abstract

Background/Objectives: The diagnosis of vestibular migraine (VM) and Meniere’s disease (MD) is based mainly on clinical criteria. The aim of this study is to systematically review and investigate the potential role of the video Head Impulse Test (vHIT) in the differential diagnosis between [...] Read more.

Background/Objectives: The diagnosis of vestibular migraine (VM) and Meniere’s disease (MD) is based mainly on clinical criteria. The aim of this study is to systematically review and investigate the potential role of the video Head Impulse Test (vHIT) in the differential diagnosis between VM and MD. Methods: A systematic review of the English-language literature was conducted, including studies from database inception to November 2023, in accordance with PRISMA guidelines. Medline (via PubMed), Cochrane Database and Scopus were reviewed. The review included studies involving adult patients diagnosed with VM, MD, or healthy control individuals who underwent vHIT and reported data on vHIT abnormalities, gain, and refixation saccades. The AXIS tool was applied for risk of bias assessment in all cross-sectional studies. A random-effects meta-analysis was performed to compare vHIT gains between individuals with VM and those with MD. Results: Eleven cross-sectional observational studies with a case–control comparison design were included, comprising a total of 362 patients with VM, 307 patients with MD, and 135 healthy control subjects. All studies applied the same diagnostic criteria for VM; however, varying criteria were used for the diagnosis of MD. Four studies evaluated the duration of vestibular symptoms, two assessed migraine duration, and six provided a rationale for excluding individuals with overlapping VM and MD diagnoses. Criteria for defining an abnormal vHIT result were specified in six studies. Seven studies reported vHIT gain values for the lateral semicircular canal, while eight presented data on saccade incidence and characteristics. Additionally, four studies were included in the meta-analysis, which yielded a mean difference in the vHIT gain of −0.0203 (95% CI: −0.0789 to 0.0383; p = 0.4968), indicating no statistically significant difference between patients with VM and those with MD. Conclusions: In this review, vHIT gain did not differ significantly between VM and MD groups, suggesting that vHIT gain alone has limited utility in their differential diagnosis. Combined saccade patterns may still prove clinically useful as more robust and consistent data become available. Full article

(This article belongs to the Section Balance)

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Audiol. Res., Volume 16, Issue 1 (February 2026) – 22 articles

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