Audiology Research

Background: Hearing loss is a highly prevalent condition in the world population that determines emotional, social, and economic costs. In recent years, it has been definitely recognized that the lack of physiological binaural hearing causes alterations in the localization of sounds and reduced speech recognition in noise and reverberation. This study aims to explore the psycho-social profile of adult workers affected by single-sided deafness (SSD), without other major medical conditions and otological symptoms, through comparison to subjects with normal hearing. Methods: This is a cross-sectional, case-control study. Subjects aged between 24 and 65 years, all currently employed and affected by SSD, were enrolled. They were administered both disease-specific and psychometric tests, such as the Hearing Handicap Inventory for Adults (HHIA), the Profile Questionnaire for Rating Communicative Performance, the Psychological General Well-Being Index (PGWBI), and the Social Functioning Questionnaire (SFQ). Results: A total of 149 subjects (mean age = 49.9; SD ± 8.5) were enrolled in the period 2021–2023; 68 were males (45.6%), and 81 were females (54.4%). The normal hearing group was composed of 95 subjects, and the SSD sample was composed of 54 subjects. The results of our study show that the levels of psychological well-being and social functioning in subjects with SSD are statistically worse than in the group of subjects with normal hearing in most subscales. Conclusions: This study definitely outlined evidence for a significantly worse psychological health status and a poorer social attitude of working adults affected by SSD with respect to their normal-hearing counterparts. Understanding the impact of SSD on patients’ work environment suggests a multidisciplinary approach to such patients in order to increase their quality of life through adequate counseling, acceptance, and role modeling. Full article

Purpose: This study examines the potential associations between salivary cortisol concentrations and subjective stress test scores in healthy individuals subjected to sound-related, psychological, and physical stressors. Methods: This study employed a single-center observational cross-sectional design, with a sample size of 36 subjects recruited from a tertiary referral audiology center. Between 2023 and 2024, the study recruited subjects with normal hearing, baseline salivary cortisol levels, and subjective stress levels. The participants were requested to complete an STAI-Y1 questionnaire and provide salivary cortisol samples before and following exposure to sound-related, psychological, and physical stress tests. Results: Exposure to psychological and physical stressors significantly increased STAI-Y1 scores (Friedman’s test, χ² = 57.118, df = 2, p = 0.377). This increase was greater than that observed in response to loud, favorite music (Friedman’s test, χ² = 57.118, df = 2, p < 0.0001). The salivary cortisol concentration significantly increased in all three provocation tests (Friedman’s test, χ² = 95.264, df = 5, p < 0.0001). Furthermore, there is no significant difference in salivary cortisol concentrations between the three pre-test and post-test measurement intervals, indicating a comparable stress-inducing pattern regardless of the nature of the stimulus (Friedman’s test, χ² = 95.264, df = 5, p > 0.05). Conclusions: Exposure to loud favorite music increases salivary cortisol concentrations, as does acute physical and psychological stress. Interestingly, unlike psychological and physical stress, loud music was not objectively perceived as stress, which may mask the physiological signs of stress, potentially increasing the risk of both acute and chronic stress-related health outcomes. Full article

Background/Objectives: Conventional audiometry assesses hearing in the frequency range of 250–8000 Hz, while humans can detect sounds from 20 to 20,000 Hz. Hearing sensitivity above 8000 Hz can be assessed through “Extended high-frequency audiometry (EHFA)”, which is useful for early detection and monitoring of hearing loss and counseling for tinnitus patients. Despite its usefulness, age significantly affects hearing sensitivity. Currently, there are no standard hearing thresholds in the EHF range categorized by age groups in Thailand. In this study, the aim was to determine normative EHFA data across different age groups in a healthy Thai population. Methods: This study included 134 participants aged 18–70 years, categorized into five age groups. All participants had normal hearing thresholds and type A tympanograms bilaterally. Following this, EHFA measurement was performed. Results: Across all age groups, there was an observed increase in median hearing thresholds as age increased. In comparison, no significant difference in median hearing thresholds was found between individuals aged 18–30 and >30–40 years. However, those over 40 years had significantly higher median thresholds across all frequencies compared to those under 40 years (p < 0.05). Based on these findings, we propose two new subgroups of 18–40 years and >40–70 years. Median hearing thresholds for those aged 18–40 was ≤20 dB HL across most frequencies, except at 16,000 Hz (30 dB HL). In the >40–70 age group, thresholds ranged from 20 dB HL at 9000 Hz to 70 dB HL at 14,000 and 16,000 Hz. However, no significant differences were found in hearing thresholds between sexes and ear sides. Conclusions: In this study, normative EHFA data were established for healthy Thai adults, appropriately divided into two groups (18–40 and >40–70 years) for clinical use. Further studies with more participants per age group are also needed to validate the results. Full article

Introduction: Acceptable Noise Level (ANL) is defined as the most comfortable level (MCL) intensity for speech and is calculated by subtracting the maximum noise tolerable by an individual. The ANL test has been used over time to predict hearing aid use and the impact of digital noise reduction. This study analyzes this impact by using different masker babble spectra when performing the ANL test in both hearing-impaired and healthy subjects in three different languages (Dutch, French, and Italian). Materials and Methods: A total of 198 patients underwent the ANL test in their native language using a standardized protocol. The babble file was speech-weighted to match the long-term spectrum of the specific ANL language version. ANL was proposed in three different masking conditions: with multitalker Matched babble speech noise, with the same masking signal with the spectrum reduced from 2 kHz onwards (High Cut), and with the spectrum increased from 2 kHz onwards (High Boost). Results: In all of the comparisons among the three languages, ANL with High Boost noise gave significantly higher (worse) scores than ANL with Matched noise (p-value S1: <0.0001, S2: <0.0001, S3: 0.0003) and ANL with High Cut noise (p-value S1: 0.0002, S2: <0.0001, S3: <0.0001). The ANL values did not show any significant correlation with age and gender. In French, a weak correlation was found between ANL with High Cut noise and the Fletcher index of the worst ear. In Italian, a weak correlation was found between both ANL with Matched and High Boost noise and the Fletcher index of the best ear. Conclusions: ANL with High Boost added to noise stimuli was less acceptable for all patients in all of the languages. The ANL results did not vary in relation to the patients’ characteristics. This study confirms that the ANL test has potential application for clinical use regardless of the native language spoken. Full article

Despite the significant advancements in hearing aid technology, their adoption rates remain low, with stigma continuing to be a major barrier for many. This review aims to assess the origins and current state of hearing aid stigma, as well as explore potential strategies for alleviating it. This review examines the societal perceptions, psychological impacts, and recent technological advancements that can influence hearing aid adoption and reduce stigma. Methods: A narrative-focused review of the literature from peer-reviewed journals and reputable sources was conducted, analyzing papers on hearing aid stigma, adoption rates, and technological solutions. The research works were categorized based on their focus on the drivers and alleviation strategies for the stigma of hearing aids. Results: This review identifies stigma as a complex, multifaceted issue driven primarily by ageism, disability perception, and the association of hearing aids with aging and incapability. Despite technological improvements, the studies surveyed listed stigma as a major factor in non-adoption. Technological advancements such as artificial intelligence in sound processing, multifunctional features, and innovative design have shown potential in reducing stigma and improving user experience. Conclusions: Alleviating the stigma of hearing aids requires a multi-pronged approach, combining improvements in technology with changes in societal perceptions. Multifunctional devices including both health and communications functions, advanced signal processing, and esthetic improvements can drive their adoption, but broader public health awareness and education are also essential to changing societal attitudes and fostering greater acceptance of hearing aids. Full article

Background: We present a feasibility study on the development of a 3D-printed (3DP) model of benign paroxysmal positional vertigo (BPPV) and its validation as an educational tool for training in therapeutic maneuvers. Methods: A 1.5:1 3DP model of the human labyrinth, supplemented by a 1:1 3DP model of the skull, was obtained from a computed tomography scan. We presented the model to 15 Emergency Medicine residents, 15 medical students, 15 Otolaryngology residents, and 15 Otolaryngology practitioners from two academic referral centers. Participants performed the Semont and Epley maneuvers on the model twice, once before and once after observing the biomechanics of BPPV using this tool. A specific survey was then administered to assess both performance improvement and satisfaction. Results: All the trainees demonstrated an improving trend on the second attempt. The medical students ameliorated significantly after the training in both Epley (p = 0.007) and Semont maneuvers (p = 0.0134). The Emergency Medicine residents improved significantly in Semont maneuvers (p = 0.0134). Self-reported understanding of the BPPV mechanics improved significantly after training in all the groups (p < 0.05). Conclusions: The preliminary data highlighted the potential benefits of training on the 3DP model for practitioners involved in the first-line management of BPPV. Full article

Background/Objectives: Understanding speech in background noise is a challenging task for listeners with normal hearing and even more so for individuals with hearing impairments. The primary objective of this study was to develop Romanian speech material in noise to assess speech perception in diverse auditory populations, including individuals with normal hearing and those with various types of hearing loss. The goal was to create a versatile tool that can be used in different configurations and expanded for future studies examining auditory performance across various populations and rehabilitation methods. Methods: This study outlines the development of Romanian speech material for speech-in-noise testing, initially presented to normal-hearing listeners to establish baseline data. The material consisted of unpredictable sentences, each with a fixed syntactic structure, generated using speech synthesis from all Romanian phonemes. A total of 50 words were selected and organized into 15 lists, each containing 10 sentences, with five words per sentence. Two evaluation methods were applied in two sessions to 20 normal-hearing volunteers. The first method was an adaptive speech-in-noise recognition test designed to assess the speech recognition threshold (SRT) by adjusting the signal-to-noise ratio (SNR) based on individual performance. The intelligibility of the lists was further assessed at the sentence level to evaluate the training effect. The second method was used to obtain normative data for the SRT, defined as the SNR at which a subject correctly recognizes 50% of the speech material, as well as for the slope, which refers to the steepness of the psychometric function derived from threshold recognition scores measured at three fixed SNRs (−10 dB, −7 dB, and −4 dB) during the measurement phase. Results: The adaptive method showed that the training effect was established after two lists and remained consistent across both sessions. During the measurement phase, the fixed SNR method yielded a mean SRT50 of −7.38 dB with a slope of 11.39%. These results provide reliable and comparable data, supporting the validity of the material for both general population testing and future clinical applications. Conclusions: This study demonstrates that the newly developed Romanian speech material is effective for evaluating speech recognition abilities in noise. The training phase successfully mitigated initial unfamiliarity with the material, ensuring that the results reflect realistic auditory performance. The obtained SRT and slope values provide valuable normative data for future auditory assessments. Due to its flexible design, the material can be further developed and extended to accommodate various auditory rehabilitation methods and diverse populations in future studies. Full article

Background/Objectives: Hearing loss in childhood is associated with significant challenges in linguistic and cognitive development, particularly affecting language skills such as syntax, semantics, and pragmatics, which are essential for effective communication and social integration. This study aimed to analyze how different types and degrees of hearing loss impact linguistic development in children, and to identify clinical factors—such as age at diagnosis and years of language intervention—that may predict language performance. Methods: This study included a sample of 140 children aged 6 to 12, categorized into seven groups based on their hearing condition: unilateral and bilateral conductive, unilateral and bilateral sensorineural, unilateral and bilateral mixed hearing loss, and a control group with no hearing loss. Linguistic development was assessed using the Clinical Evaluation of Language Fundamentals-5 (CELF-5), a validated tool for diagnosing language disorders. Statistical analyses, including MANOVA and multiple regression, were conducted to evaluate differences in linguistic skills across groups and to determine the predictive value of clinical variables on total language performance. Results: The analysis revealed statistically significant differences across groups in all assessed linguistic domains (p < 0.001), with children with severe or bilateral hearing loss exhibiting notably lower scores compared to normohearing peers. The multiple regression analysis indicated that type of hearing loss was the strongest predictor of total linguistic performance (β = −0.674), followed by age at diagnosis (β = −0.285) and age of hearing device adaptation (β = −0.220). Years of language intervention also contributed significantly (β = 0.198) but to a lesser extent. Conclusions: This study highlights the critical impact of early and comprehensive auditory and language intervention on linguistic outcomes for children with hearing impairments. Early diagnosis and timely adaptation of hearing aids or cochlear implants are essential in mitigating language deficits, particularly in areas like syntax and pragmatic skills. These findings support the need for specialized, long-term interventions tailored to the severity and type of hearing loss to improve language development in this population. Full article

Background/Objectives: Tinnitus is a debilitating auditory disorder commonly described as a ringing in the ears in the absence of an external sound source. Sound trauma is considered a primary cause. Neuronal hyperactivity is one potential mechanism for the genesis of tinnitus and has been identified in the cochlear nucleus (CN) and the auditory cortex (AC), where there may be an imbalance of excitatory and inhibitory neurotransmissions. However, no study has directly correlated tinnitus with the extracellular levels of amino acids in the CN and the AC using microdialysis, which reflects the functions of these neurochemicals. In the present study, rats were exposed to acoustic trauma and then subjected to behavioural confirmation of tinnitus after one month, followed by microdialysis. Methods: Rats were divided into sham (aged, n = 6; young, n = 6); tinnitus-positive (aged, n = 7; young, n = 7); and tinnitus-negative (aged, n = 3; young, n = 3) groups. In vivo microdialysis was utilized to collect samples from the CN and the AC, simultaneously, in the same rat. Extracellular levels of amino acids were quantified using high-performance liquid chromatography (HPLC) coupled with an electrochemical detector (ECD). The effects of sound stimulation and age on neurochemical changes associated with tinnitus were also examined. Results: There were no significant differences in either the basal levels or the sound stimulation-evoked changes of any of the amino acids examined in the CN and the AC between the sham and tinnitus animals. However, the basal levels of serine and threonine exhibited age-related alterations in the AC, and significant differences in threonine and glycine levels were observed in the responses to 4 kHz and 16 kHz stimuli in the CN. Conclusions: These results demonstrate the lack of a direct link between extracellular levels of amino acids in the CN and the AC and tinnitus perception in a rat model of tinnitus. Full article

Background: Bilateral vestibulopathy (BVP) is a disabling condition characterized by a deficit in vestibular function on both sides. Current diagnostic criteria consider instrumental data only from horizontal canals, excluding vertical canals and otolithic function, with the possibility of not including some variants of BVP. This study aims to evaluate vestibular functions in people with chronic vestibular syndrome through a comprehensive battery of tests. Methods: This diagnostic accuracy study included patients who met criteria for probable BVP. The index test included a thorough evaluation of the vestibular system, using the video Head Impulse Test (vHIT) to measure the gain of the angular vestibulo-ocular reflex (aVOR) in all six semicircular canals and the cervical and ocular vestibular-evoked myogenic potentials (VEMPs) to assess otolith function. The diagnostic criteria established by the Barany Society were considered the standard reference, including only the horizontal vHIT as an instrumental assessment. Results: 78 patients (41 male, age 61.40 ± 12.99) were enrolled. The Barany criteria showed a low ability to rule out BPV (sensitivity = 46%). The median Dizziness Handicap Inventory (DHI) varied from 66 to 69 among the models studied, and a significant difference in DHI scores between positive and negative tests was observed for the Barany criteria and the six-canals vHIT model. Conclusions: Our findings highlight the potential to transform BPV diagnostic criteria. The identification of new bilateral vestibular dysfunction variants through improved diagnostic tools calls for revising current criteria, with promising implications for patient care and understanding of etiological and prognostic aspects. Full article

Background/Objectives: An air–bone gap (ABG) on audiometry is usually secondary to a conductive hearing loss. However, persistent and repeatable ABGs on audiometry in the absence of external or middle ear pathology is thought to arise from inner ear disorders including Meniere’s Disease (MD). In this paper, we aim to showcase this interesting finding occurring in MD with an associated literature review. Methods: Using retrospective review and analysis of case notes, we describe eight cases of persistent ABG on audiometry in MD. All other causes for the ABG were explored and excluded with the aid of objective audiological testing. Results: ABG can occur in a small sub-set of the MD population. In our case series, the ABG was typically found to affect the low frequencies. Higher frequencies appear to be spared. However, a detailed history, examination and battery of objective tests are required to ensure that all other causes of the ABG are reliably considered and excluded prior to attributing it to the inner ear. The finding of an ABG in MD may be dependent on the stage of the disease. Further research is required to determine the underlying cause of the ABG and its potential applications to help guide treatment. Full article

Background: Vestibular Neuritis (VN) can induce unilateral acute vestibular syndrome (AVS). This study aimed to identify predictive factors of recovery from vestibular neuritis considering total restitution and/or compensation. Methods: In this longitudinal study, 40 patients were included. The initial assessment, performed within 36 to 72 h from the onset (T0), included medical history taking (general and specific), including screening for cardiovascular risk factors (CVRFs), and a battery of diagnostic vestibular tests, comprising the bithermal caloric test (BCT), video head impulse test (VHIT), and skull vibration-induced nystagmus (SVIN) test. All patients also completed a Dizziness Handicap Inventory (DHI). All assessments were repeated 90 ± 15 days later (T3). Subjective compensation criteria were based on the DHI total score, and objective compensation criteria were based on laboratory test results. Four groups of patients (A, B, C, D) were delineated by combining patients with normal vs. abnormal vestibular tests and patients with normal vs. abnormal DHI. Results: CVRFs (but not age or body mass index (BMI)) were associated with a poorer recovery of symptoms. The BCT (lateral semicircular canal paresis %), VHIT (lateral semicircular canal gain), and SVINT (nystagmus slow phase velocity) recovered to normal values in 20%, 20%, and 27% of patients, respectively, at T3. Conclusions: Vascular risk factors (hypercholesterolemia) are correlated with patients who do not recover their symptoms via either total restitution or compensation. There was no significant difference between high- and low-frequency vestibular tests in patients recovering from their symptoms. Some patients with objective recovery may continue to have persistent subjective symptoms. Full article

(1) Background: Surgery for Chiari I malformation (CMI) is indicated when typical clinic-radiological features (syringomyelia, exertional headaches, sleep apnea syndrome, and tetraparesis) are present. Sometimes, patients have atypical complaints suggestive of otolaryngological (ENT) involvement, and it is sometimes difficult for the neurosurgeon to determine if these complaints are related to the CMI. Our aim was to describe postural control patterns in children with CMI using computerized dynamic posturography. To our knowledge, this is the first study addressing postural instability in pediatric CMI patients. (2) Methods: Twenty-eight children aged 6 to 17 years with both radiologically confirmed CMI and clinical ENT complaints were included. The children were separated into two groups, operated and non-operated patients, based on neurosurgical indication. Epidemiologic and posturographic results (CDP—Equitest^®) were compared between both groups, as well as pre- and postoperatively in Group 2. (3) Results: In Group 2 patients, significant improvement of global SOT was found after intervention. When the three sensorial aspects of postural control calculated by the system were independently assessed, the greatest improvement was in the vestibular ratio. We also observed an altered CoG pattern (“lateral deviation”) in the Group 2 patients, which significantly differed from those in Group 1. Lateral deviation was significantly reduced postoperatively in the Group 2 patients. A correspondence between preoperative MRI and the side of lateralization on posturography was found in four children, but this cannot be regarded as significant due to the low number of patients. (4) Conclusions: Postural control seems to improve after surgery for CMI in children, mostly due to the improvement in vestibular function. There is a correspondence between the side of lateral deviation and the side of greatest tonsillar descent on MRI and perioperatively. Further studies are needed to support these results and to confirm the utility of CDP in CMI patients. Full article

Objectives: Sensitivity to the gliding of ripples in rippled-spectrum signals was measured in both normal-hearing and hearing-impaired listeners. Methods: The test signal was a 2 oct wide rippled noise centered at 2 kHz, with the ripples gliding downward along the frequency scale. Both the gliding velocity and ripple density were frequency-proportional across the signal band. Ripple density was specified in ripples/oct and velocity was specified in oct/s. The listener’s task was to discriminate between the signal with gliding ripples and the non-rippled signal. Results: In all listener groups, increasing the ripple density decreased the maximal velocity of detectable ripple gliding. The velocity limit of ripple gliding decreased with hearing loss. Conclusions: The results can be explained by deteriorated temporal resolution in hearing-impaired listeners. Full article

Background/Objectives: Bimodal stimulation (BS), which combines the use of a cochlear implant (CI) in one ear and a hearing aid (HA) in the opposite ear, is an established strategy to treat hearing loss by exploiting the unique capabilities of each device. CIs stimulate the auditory nerve by bypassing damaged hair cells, while HAs amplify sounds by requiring a functional hearing residual. The aim of this systematic review is to investigate the advantages and disadvantages of BS such as speech perception in noise. Methods: We examined clinical studies published from October 2020 to July 2024, following the PRISMA guidelines, focusing on the advantages and disadvantages of BS on speech perception in noise in adulthood. Results: BS in adult patients significantly improves speech perception in quiet and noisy environments, especially for those with increased residual hearing. Unilateral CIs and BS perform similarly in quiet conditions, but BS significantly improves speech discrimination in noisy environments if loudness between the two devices is appropriately balanced. Conclusions: Directional microphones and programming software are new technologies that succeed in reducing environmental noise and improving verbal perception outcomes, although their features in the literature are controversial. In addition, the individuals using BS may face temporal mismatches mainly due to differing device latencies, affecting sound localization. Compensating for these mismatches can enhance localization accuracy. However, modulated noise remains a significant obstacle to verbal perception in noise. Valuable assessment tools such as music tests provide further information on hearing performance and quality of life. More research is needed to define certain selection criteria. Full article

Objectives: This study aims to measure, at two time points, the relationship between self-perceived global stress and the personality traits of the mothers of children who have central auditory processing disorder (APD) and compare it with the results from mothers of typically developing (TD) children. The comparisons were made before the COVID-19 pandemic, as well as late in the pandemic. Methods: The level of stress was assessed using the Perceived Stress Scale (PSS-10), while the Short Big Five Markers (IPIP-BFM-20) were used to assess Big Five personality traits. The study used two independent samples: one evaluated before the COVID-19 pandemic and the other late in the pandemic. Each sample consisted of 108 mothers of children with APD and 79 mothers whose children did not have APD (TD children) as controls. Results: The average global stress levels were similar in mothers of children with APD and in mothers of TD children, both before and in the late stage of the COVID-19 pandemic. During the late stage, both sets of mothers scored similarly on all personality dimensions, but significantly, mothers of TD children exhibited lower emotional stability compared to during the pre-pandemic period. In both groups, emotional stability predicted global stress level at both time points; however, during the pandemic, conscientiousness also became a predictor of global stress level but only in the group of mothers of TD children. Conclusions: Mothers of APD children might be more resistant to additional stressors. It would be prudent to watch mothers of APD and TD children for signs of needing psychological intervention. Full article

Objectives. This study aimed to compare the audiological benefits of a non-implantable wearable option for a bone conduction (BC) implant mounted on an arch (SoundArc) to those of traditional BC hearing aids (HAs) mounted on eyeglasses (BCHAs) in patients with moderate to severe conductive or mixed hearing loss. Methods: A preliminary cross-sectional observational prospective cohort study was conducted in the Tertiary Audiological Department, University Hospital. Fourteen adults with conductive or mixed hearing loss (PTA at 0.5-1-2-4 KHz = 67 ± 15 dB HL) who had been wearing conventional BCHAs mounted on eyeglasses for at least 3 years and had declined surgical implantation of a bone conduction hearing implant (BCHI) were included in the study. Unaided and aided pure-tone air conduction (AC) and bone conduction (BC) thresholds, as well as speech tests in quiet and noise, were recorded at baseline and in two different settings: with a BCHI mounted on SoundArc^® and with their own BCHAs mounted on eyeglasses using two couplers. Participants completed questionnaires in both conditions, including the International Inventory for Hearing Aids (IOI-HA), the Hearing Handicap Inventory for Adults/Elderly (HHIA/E), the Speech, Spatial, and Qualities of Hearing Scale (SSQ), a 10-point visual analog scale (VAS), and the Fatigue Impact Scale (FIS). Results: A significant functional gain was observed in both settings (p = 0.0001). Better speech perception in quiet and noise was observed with SoundArc compared to conventional BCHAs on eyeglasses (improvements in word repetition scores in noise: +19.3 at SNR +10 dB, p = 0.002; +12.1 at SNR 0 dB, p = 0.006; and +11.4 at SNR −10 dB, p = 0.002). No significant differences were found in IOI-HA, FIS, and HHIA/E scores. However, significantly better SSQ scores were reported for SoundArc in all domains (p = 0.0038). Conclusions: Although patients were accustomed to using BCHAs mounted on eyeglasses, the bone conduction wearable option of the BCHI (SoundArc) proved to be a viable alternative for adult patients with conductive or mixed hearing loss who are unable or unwilling to undergo BCHI surgery. Full article

Background: Limited information is available on factors that affect the burden tinnitus. The aim of this study is to investigate the association between tinnitus burden and demographic, patient-specific and tinnitus characteristics. Secondly, it was examined which variables could predict a change in tinnitus burden after 12 months. Method: In a prospective Dutch cohort of 383 tinnitus patients seeking medical help, tinnitus complaints, demographics, tinnitus characteristics, psychological wellbeing and quality of life were assessed using an online self-report survey at three timepoints (start, 6 months, 12 months). The main outcome variables for tinnitus burden are the Tinnitus Questionnaire (TQ) and Visual Analog Scale (VAS) for tinnitus burden and loudness. Results: Several variables (time, sex, education level, life events, anxiety and depression, sleep issues, tinnitus loudness, hearing impairment and treatment) were significantly associated with tinnitus burden. Additionally, tinnitus burden after 12 months was associated with anxiety, following treatment, sleep issues, negative life events and hearing impairment (increase) and anxiety, total of life events and environmental quality of life (decrease) predicted the tinnitus burden after 12 months. Conclusions: Several factors, such as education level, life events, psychological factors and sleep quality, are related to tinnitus burden and can predict tinnitus burden over time. Full article

Background: Speech recognition in noise is one of the difficulties faced by people with hearing loss that increases with age. The recently developed Spanish Auditory Test of Speech in Noise (Prueba Auditiva de Habla en Ruido en Español, PAHRE) allows for the identification of these intelligibility difficulties in noise. The aim of this study was to assess speech recognition in noise in people with hearing loss and to test the benefits of the Lombard effect. Methods: The participants were 104 people with hearing difficulties, ranging in age from 37 to 98 years. The variables age, degree of hearing loss, presence of high-frequency dropout, and years of formal education were assessed. Results: Psychometric curves were obtained as a function of signal-to-noise ratio as well as threshold values of speech reception as a function of age group for mild and moderate hearing loss. The results indicated that the speech reception threshold increased with both age and the degree of hearing loss, becoming particularly significant after the age of 70. Furthermore, it was found that the combined factors of age, degree of hearing loss, and educational level predicted a high percentage of the variability in the speech reception threshold. Conclusions: Therefore, the Spanish Auditory Test of Speech in Noise could be a useful clinical tool for diagnosis, monitoring, auditory rehabilitation planning, and hearing aid fitting. Full article