Audiology Research

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

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

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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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

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

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

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

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

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

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

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

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

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

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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30 pages, 4367 KB

Open AccessArticle

Effects of StereoBiCROS on Speech Understanding in Noise and Quality of Life for Asymmetric Sensorineural Hearing Loss

by Morgan Potier, Arnaud Noreña, Fabien Seldran, Mathieu Marx and Stéphane Gallego

Audiol. Res. 2025, 15(6), 176; https://doi.org/10.3390/audiolres15060176 - 16 Dec 2025

Abstract

Background and Aim: Asymmetric sensorineural hearing loss is difficult to rehabilitate acoustically. Bilateral amplification may induce binaural interference, while CROS/BiCROS systems provide benefit only when the speech signal reaches the poorer ear. A hybrid approach combining CROS strategy with bilateral acoustic amplification, [...] Read more.

Background and Aim: Asymmetric sensorineural hearing loss is difficult to rehabilitate acoustically. Bilateral amplification may induce binaural interference, while CROS/BiCROS systems provide benefit only when the speech signal reaches the poorer ear. A hybrid approach combining CROS strategy with bilateral acoustic amplification, called Stereophonic Bilateral Contralateral Routing of Signal—StereoBiCROS—has recently emerged. Methods: A one-month home trial was conducted with hearing aids programmed in three listening modes: Stereophonic, BiCROS, and StereoBiCROS. Speech-in-noise perception was assessed in dichotic and reverse-dichotic conditions. Speech recognition thresholds were derived using logistic regression. Daily mode usage was extracted from datalogging. Pre/post subjective benefit was evaluated using the SSQ-15 and SF-12. Results: Eighteen participants (mean age 70.7 ± 8.2 years) used the devices 12.4 ± 1.6 h per day, predominantly in StereoBiCROS mode (76.9 ± 24.2%). In the dichotic condition, this mode yielded the best speech-to-noise ratio (0.96 ± 2.74 dB; p < 0.0001), outperforming unilateral rerouting (3.00 ± 2.05 dB; p = 0.001) and bilateral amplification (5.16 ± 1.31 dB; p = 0.001). In the reverse-dichotic condition, only bilateral amplification provided a non-significant improvement (3.08 ± 1.38 dB), whereas the other modes deteriorated intelligibility. SSQ-15 total and subscale scores significantly improved after one month, while SF-12 scores did not change. Conclusions: StereoBiCROS stimulation appears to be a promising acoustic alternative for improving speech intelligibility in noise and patient-reported outcomes in asymmetric sensorineural hearing loss. Further research is required to identify the most responsive audiological profiles. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment—Volume II)

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14 pages, 1426 KB

Open AccessArticle

Trends and Incidence of Hearing Implant Utilization in Italy: A Population-Based Study

by Enrico Ciminello, Domenico Cuda, Francesca Forli, Anna Rita Fetoni, Stefano Berrettini, Eugenio Mattei, Tiziana Falcone, Adriano Cuccu, Paola Ciccarelli, Stefania Ceccarelli and Marina Torre

Audiol. Res. 2025, 15(6), 175; https://doi.org/10.3390/audiolres15060175 - 14 Dec 2025

Abstract

Background/Objectives: Cochlear implants (CIs) and other implantable hearing devices are crucial to treat hearing loss. The aim of this study was to analyze the temporal trends of implantation for hearing devices in Italy between 2001 and 2023, with stratification by age. Methods: This [...] Read more.

Background/Objectives: Cochlear implants (CIs) and other implantable hearing devices are crucial to treat hearing loss. The aim of this study was to analyze the temporal trends of implantation for hearing devices in Italy between 2001 and 2023, with stratification by age. Methods: This population-based study explored Hospital Discharge Records and used codes from the International Classification of Diseases, 9th revision—Clinical Modification (ICD9-CM) to identify cochlear and non-cochlear implants. Patients were partitioned into six age classes: <1, 1–2, 3–17, 18–65, 66–80, and >80; and time series for counts and incidence rates (IRs) per 1,000,000 inhabitants with confidence intervals (CI_95%) were explored overall and by age class. Trends were assessed by incidence rate ratio and Cox–Stuart test with a significance threshold for p-values at 0.05. Results: 22,850 (83.6%) records for cochlear and 4476 (16.4%) for non-cochlear implants were extracted. Cochlear implants volume shifted from 537 procedures in 2001 to 1595 in 2023 (p < 0.01), while IR increased (p < 0.01) from 9.4 (CI_95%: 9.7, 10.3) in 2001 to 27 (CI_95%: 25.7, 28.4) in 2023. The volumes of implanted CIs increased in children and adults. Volumes for non-cochlear implants increased between 2001 and 2010, from 62 to 254, and remained stable afterwards. IR shifted from 1.1 (CI_95%: 0.8, 1.4) in 2001 to 4.1 (CI_95%: 3.6, 4.7) in 2023. Conclusions: Those trends highlight the importance of monitoring efficacy and safety of hearing devices, and the establishment of the Italian Implantable Hearing Device Registry at the Italian National Institute of Health is a first step in such a direction. Full article

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18 pages, 987 KB

Open AccessSystematic Review

Hearing Loss in Young and Middle-Aged Adults as a Modifiable Risk Factor for Late-Life Dementia: A Systematic Review and Meta-Analysis

by Lakshmi Satheesan, Usha Shastri, Gagan Bajaj and Mohan Kumar Kalaiah

Audiol. Res. 2025, 15(6), 174; https://doi.org/10.3390/audiolres15060174 - 12 Dec 2025

Abstract

Background: Individuals with untreated hearing loss often experience cognitive decline as a result of increased cognitive load and reduced sensory stimulation. Despite the well-established link between untreated hearing loss and cognitive decline in older adults, its impact on cognition in young and middle-aged [...] Read more.

Background: Individuals with untreated hearing loss often experience cognitive decline as a result of increased cognitive load and reduced sensory stimulation. Despite the well-established link between untreated hearing loss and cognitive decline in older adults, its impact on cognition in young and middle-aged adults has not been systematically examined. Given the Lancet Commission’s identification of midlife hearing loss as the leading modifiable risk factor for dementia, early identification of cognitive decline is essential. This review explored the cognitive impact of untreated hearing loss in adults. Method: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and EMBASE to include studies comparing cognitive function between adults with normal hearing and those with untreated hearing loss aged 18–65 years. The methodological quality of the included studies was examined via the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Pooled mean differences and heterogeneity were analysed for each domain. Results: Seven studies included in the qualitative synthesis had “moderate” to “strong” methodological quality. The cognitive domains assessed in these studies were global cognitive function, memory, attention, and executive function. Of these, six were eligible for meta-analysis, which revealed a small but statistically significant decline in overall cognitive performance and memory and executive function among adults with untreated hearing loss. Conclusions: Cognitive vulnerabilities exist in young and middle-aged adults with untreated hearing loss. Hence, incorporating cognitive assessment into routine audiological evaluation may enable earlier intervention and delay the future burden of Alzheimer’s disease and related dementias in such a population. Full article

(This article belongs to the Section Hearing)

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26 pages, 1300 KB

Open AccessArticle

Digital Tinnitus Counseling in Clinical Practice: A Multicenter Randomized Controlled Trial

by Petra Brueggemann, Gernot G. Supp, Paul Schmidt and Birgit Mazurek

Audiol. Res. 2025, 15(6), 173; https://doi.org/10.3390/audiolres15060173 - 9 Dec 2025

Abstract

Background/Objectives: Subjective tinnitus, defined as the perception of sound without an external source, is a common and often debilitating condition. In the absence of pharmacotherapy, disease management guidelines recommend counseling interventions to alleviate tinnitus-related distress and improve patient outcome. This study evaluated [...] Read more.

Background/Objectives: Subjective tinnitus, defined as the perception of sound without an external source, is a common and often debilitating condition. In the absence of pharmacotherapy, disease management guidelines recommend counseling interventions to alleviate tinnitus-related distress and improve patient outcome. This study evaluated the benefit of guideline-compliant counseling provided by “Meine Tinnitus App”, a smartphone-based application, for the treatment of subjective tinnitus. Methods: A randomized controlled study was conducted in 204 patients with confirmed chronic subjective tinnitus enrolled at 33 ear, nose and throat (ENT) practices in Germany. Tinnitus improvement was evaluated after 10 weeks of intervention (digital counseling in addition to standard care vs. standard care only). The primary endpoint was the change in tinnitus-related distress (measured by the Mini-TQ-12 validated questionnaire). The secondary endpoint was the change in tinnitus-associated daily burden and coping difficulties (measured by the validated BVB-2000 questionnaire). Treatment effects for the primary and secondary endpoints were represented by the estimated marginal means (EMMs). Results: Patients of the intervention group showed a significant reduction in tinnitus-related distress (EMM [95% CI]: 4.5 [3.3–5.8]; p < 0.001) and a significant improvement in tinnitus-associated daily burden and coping difficulties (EMM [95% CI]: 0.5 [0.2–0.7]; p < 0.001) compared to patients of the control group, with large to moderate effect sizes (Hedges’ g between 1.1. and 0.5). These positive treatment effects were confirmed by responder and sensitivity analyses. Additionally, patients with high vs. low app usage showed a greater improvement in treatment effect for both endpoints (p < 0.05), further supporting the health benefits of digital counseling. Conclusions: This study demonstrated the efficacy of tinnitus counseling provided by “Meine Tinnitus App” to alleviate tinnitus-related distress, daily burden, and coping difficulties in patients with subjective tinnitus (German Clinical Trials Register DRKS00025379). Full article

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

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13 pages, 980 KB

Open AccessArticle

Early Speech Development in Romanian Children with Cochlear Implants Assessed Using the LittlEARS^® Early Speech Production Questionnaire (LEESPQ)

by Alina Catalina Ivanov, Luminita Radulescu, Cristian Neagos, Sebastian Cozma, Corina Butnaru, Raluca Olariu, Petronela Moraru, Violeta Necula and Cristian Martu

Audiol. Res. 2025, 15(6), 172; https://doi.org/10.3390/audiolres15060172 - 8 Dec 2025

Abstract

Objective: The aim of the study was to evaluate the validity, clinical applicability, and developmental sensitivity of the Romanian LEESPQ in children with cochlear implants (CIs), by analyzing its association with age at implantation, duration of auditory experience, and implantation laterality, and by [...] Read more.

Objective: The aim of the study was to evaluate the validity, clinical applicability, and developmental sensitivity of the Romanian LEESPQ in children with cochlear implants (CIs), by analyzing its association with age at implantation, duration of auditory experience, and implantation laterality, and by comparing the developmental trajectory with that of normal-hearing (NH) children. Methods: The study assesses the validity, reliability, and clinical sensitivity of the LEESPQ in pediatric cochlear implant users. Furthermore, it investigates the associations between total questionnaire scores and key clinical variables, including implantation laterality (unilateral versus bilateral), age at device activation, and duration of implant use. Forty-seven children with CIs (26 boys, 21 girls) were included, with implantation ages ranging from 9 months to 5 years. Of these, 21 received unilateral implants and 26 bilateral implants. Responses were analyzed both in relation to clinical variables and in comparison with available normative data from NH children, in order to delineate potential differences in linguistic developmental trajectories. Results: Findings suggest that the LEESPQ is a reliable and clinically valuable instrument for monitoring post-implant linguistic progress. It provides relevant insights into early auditory access, the linguistic environment within the family, and the development of early verbal production. Scores were significantly influenced by age at implantation and duration of auditory experience, confirming the role of early stimulation and neural plasticity in shaping speech development after cochlear implantation. Conclusions: The LEESPQ demonstrates strong clinical utility as a sensitive tool for monitoring early preverbal and verbal development in children with CIs. By capturing score variations associated with age at implantation, auditory experience, and implantation laterality, the questionnaire provides meaningful insights into early post-implant outcomes and supports individualized rehabilitation planning. These findings highlight the value of the LEESPQ for early outcome assessment in pediatric cochlear implant users. Full article

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11 pages, 1251 KB

Open AccessArticle

Awareness of Noise-Induced Hearing Loss Related to Exposure to High-Noise Environments—Case Study: Young Adults 18 to 30 in Greece

by Nikolaos Trimmis, Melina Kaparou, Theodoros Tsoukalas, Panagiotis Plotas and Voula Chris Georgopoulos

Audiol. Res. 2025, 15(6), 171; https://doi.org/10.3390/audiolres15060171 - 5 Dec 2025

Abstract

Background: Noise-induced hearing loss (NIHL) is one of the most common types of hearing impairment, even though it is preventable. However, awareness and protective behaviors among young adults remain limited. This study explored the knowledge, attitudes, and behaviors of young adults in Greece [...] Read more.

Background: Noise-induced hearing loss (NIHL) is one of the most common types of hearing impairment, even though it is preventable. However, awareness and protective behaviors among young adults remain limited. This study explored the knowledge, attitudes, and behaviors of young adults in Greece regarding exposure to high-noise environments and the risk of NIHL. Methods: A cross-sectional survey was conducted with 104 participants aged 18–30 years in Patras, Greece. A 27-item questionnaire was used to collect data on demographics, patterns of noise exposure, use of personal listening devices, auditory symptoms, and preventive behaviors. Descriptive statistics and chi-square tests were used to examine relationships between demographic variables and participants’ responses. Results: Most participants (93.3%) recognized that prolonged exposure to high noise levels can harm hearing. However, only 6.7% reported having regular hearing checks, and almost half (45.2%) had never been tested. Remarkably, 19.2% of participants experienced tinnitus, while more than half (54.8%) reported fatigue after exposure to loud sounds. Younger participants (aged 18–22 years) were significantly more likely to listen at high volumes compared to older groups (p < 0.05). Males reported higher rates of tinnitus and ear discomfort, whereas females more often experienced headaches. Although general awareness of NIHL was high, preventive behaviors such as using hearing protection were rarely practiced. Conclusions: These findings highlight the need for targeted educational campaigns and preventive screening programs to promote safe listening practices and reduce the overall prevalence of NIHL. Full article

(This article belongs to the Section Hearing)

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12 pages, 439 KB

Open AccessArticle

Hearing Abilities in Children with Perinatally Acquired HIV, Children Perinatally Exposed to HIV but Uninfected, and Children Unexposed to HIV

by Peter Torre III, Haley Elliott, Zhongli J. Zhang, Tzy-Jyun Yao and Barbara Laughton

Audiol. Res. 2025, 15(6), 170; https://doi.org/10.3390/audiolres15060170 - 5 Dec 2025

Abstract

Background/Objectives: Children with perinatal HIV (PHIV) are more at risk for hearing loss than HIV-unexposed (HU) children. Due to medical advances maternal HIV transmission to newborns is decreasing, but in children with perinatal HIV exposure, uninfected (PHEU) is increasing. The objectives were [...] Read more.

Background/Objectives: Children with perinatal HIV (PHIV) are more at risk for hearing loss than HIV-unexposed (HU) children. Due to medical advances maternal HIV transmission to newborns is decreasing, but in children with perinatal HIV exposure, uninfected (PHEU) is increasing. The objectives were to evaluate (1) pure-tone audiometry and cochlear and auditory neural function in children with perinatally acquired HIV (PHIV), children with perinatal HIV exposure but uninfected (PHEU), and HIV-unexposed (HU) children and (2) differences in hearing measures for children with PHIV according to HIV disease severity. Methods: Three hundred and thirty-three children (105 PHIV [58 girls, 47 boys], 101 PHEU [51 girls, 50 boys], and 127 HU [65 girls, 62 boys]), aged 11–14 years, completed a hearing assessment that included a hearing-related questionnaire, otoscopy, tympanometry, pure-tone thresholds, distortion product otoacoustic emissions (DPOAEs) for cochlear function, and auditory brainstem responses (ABRs) for neural function. Results: Pure-tone thresholds, DPOAE, and ABR measures were similar in the three groups. Children with PHIV had a higher prevalence of hearing loss compared to children with PHEU and HU children. Children with PHIV and greater historical HIV disease severity had similar hearing, DPOAEs, and ABRs to those with lesser HIV disease severity. Conclusions: In utero HIV acquisition or HIV exposure might not affect the cochlear and neural function up to the level of the brainstem. Children with PHIV had a higher prevalence of hearing loss; it is possible there is a difference in central auditory processing across the three groups of children. Hearing loss identification is important since it may impact social and educational development. Full article

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