Journal Description
Audiology Research
Audiology Research
is an international, peer-reviewed, open access journal on audiology and neurotology, published bimonthly online by MDPI (since Volume 10, Issue 2 - 2020). The Italian Society of Vestibology (VIS) is affiliated with Audiology Research and its members receive discounts on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), PubMed, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Audiology and Speech-language Pathology) / CiteScore - Q2 (Otorhinolaryngology)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 21 days after submission; acceptance to publication is undertaken in 2.9 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Impact Factor:
1.8 (2024);
5-Year Impact Factor:
1.8 (2024)
Latest Articles
Questioning the Usefulness of Stimulation Rate Changes to Optimize Perception in Cochlear Implant Users
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
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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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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.
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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.
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(This article belongs to the Special Issue Impact of Brainstem Diseases on Hearing, Balance, Speech and Swallowing)
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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)
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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.
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(This article belongs to the Section Balance)
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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
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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.
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(This article belongs to the Section Hearing)
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Open AccessArticle
Translation and Validation of the Portuguese Version of European School for Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ-PT)
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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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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
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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.
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Open AccessSystematic Review
The Use of vHIT in the Differential Diagnosis Between Vestibular Migraine and Meniere’s Disease: A Systematic Review and Meta-Analysis
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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
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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.
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(This article belongs to the Section Balance)
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Open AccessArticle
Effects of StereoBiCROS on Speech Understanding in Noise and Quality of Life for Asymmetric Sensorineural Hearing Loss
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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,
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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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Open AccessArticle
Trends and Incidence of Hearing Implant Utilization in Italy: A Population-Based Study
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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
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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
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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 (CI95%) 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 (CI95%: 9.7, 10.3) in 2001 to 27 (CI95%: 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 (CI95%: 0.8, 1.4) in 2001 to 4.1 (CI95%: 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.
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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
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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
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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.
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(This article belongs to the Section Hearing)
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Open AccessArticle
Digital Tinnitus Counseling in Clinical Practice: A Multicenter Randomized Controlled Trial
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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
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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).
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(This article belongs to the Special Issue Emerging Technologies in Audiology: Advancing Assessment, Intervention, and Accessibility)
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Open AccessArticle
Early Speech Development in Romanian Children with Cochlear Implants Assessed Using the LittlEARS® Early Speech Production Questionnaire (LEESPQ)
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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
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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
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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.
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Open AccessArticle
Awareness of Noise-Induced Hearing Loss Related to Exposure to High-Noise Environments—Case Study: Young Adults 18 to 30 in Greece
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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
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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.
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(This article belongs to the Section Hearing)
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Open AccessArticle
Hearing Abilities in Children with Perinatally Acquired HIV, Children Perinatally Exposed to HIV but Uninfected, and Children Unexposed to HIV
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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
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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
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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.
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Open AccessArticle
Listening Effort and Its Relation to Spatial Localization, and Vestibular and Visual Impairment in Usher Syndrome—Our Experience
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Tiziana Di Cesare, Paola Michieletto, Maria Teresa Bonati, Federica De Caro, Pietro Cossu, Francesco Torelli and Eva Orzan
Audiol. Res. 2025, 15(6), 169; https://doi.org/10.3390/audiolres15060169 - 5 Dec 2025
Abstract
Background/Objectives: Children with hearing loss (HL) could experience significant fatigue which compromises their performance. The effort related to the combination of HL and visual impairment in children affected by Usher syndrome (USH) could compromise mental health, socio-emotional behavior and academic achievement. The aim
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Background/Objectives: Children with hearing loss (HL) could experience significant fatigue which compromises their performance. The effort related to the combination of HL and visual impairment in children affected by Usher syndrome (USH) could compromise mental health, socio-emotional behavior and academic achievement. The aim of the present study was to analyse the listening effort in USH cases types 1 and 2 and its relation to age, molecular diagnosis, visual field, visual acuity, degree of HL, vestibular impairment and spatial orientation. Methods: This was a retrospective monocentric study. Twenty children with genetically confirmed USH (USH2 in 15/20–75% and USH1 in 5/20–25%), age range 3–17 years (mean 9.6 ± 4.7), underwent: the Vanderbilt fatigue scale questionnaire (VFS), audiological and vestibular assessment including the Oldenburg Matrix test in Italian and video head impulse test (VHIT), sound localization test and ophthalmologic examination. Results: We observed a more pronounced HL and deteriorated vestibular function in those with USH1. They also employed significantly more time and head movements to localize sounds compared to USH2 and had the worst visual field on eye examination. The VFS did not show significant differences between the two groups, with the exception of the physical fatigue reported by parents. Mean VFS was linearly related to age, the hearing threshold of the worse ear, data logging hours of hearing device, time and head movements of the localization test, VHIT asymmetry and balance problems referred by parents and the visual field. USH type 1 had no greater risk of fatigue than USH2. Profound hearing loss, data logging of hearing device < 8 h a day, difficult localization test, balance problems and low retinal sensitivity represented risk factors for listening effort measured with VFS. Conclusions: Listening effort in difficult environments such as school rooms in USH patients is not only associated to hearing function but also to the spatial awareness determined in part by vestibular and visual function. Teachers should be informed and made aware of multiple comorbidities in order to facilitate learning.
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(This article belongs to the Section Hearing)
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Open AccessReview
Multidisciplinary Management of Cerebellopontine Angle Tumors with Brainstem Involvement
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Concheri Stefano, Vito Pontillo, Alberto D’Amico, Stefano Di Girolamo, Francesco Signorelli, Elisabetta Zanoletti and Nicola Antonio Adolfo Quaranta
Audiol. Res. 2025, 15(6), 168; https://doi.org/10.3390/audiolres15060168 - 4 Dec 2025
Abstract
Background/Objectives: Tumors of the cerebellopontine angle (CPA) encompass a limited range of histologies, predominantly vestibular schwannomas (VSs), meningiomas, and paragangliomas (PGLs). Their growth region threatens the cranial nerves (V–XII), brainstem, and cerebellum, possibly causing functional deficits. This review aims to synthesize clinical features
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Background/Objectives: Tumors of the cerebellopontine angle (CPA) encompass a limited range of histologies, predominantly vestibular schwannomas (VSs), meningiomas, and paragangliomas (PGLs). Their growth region threatens the cranial nerves (V–XII), brainstem, and cerebellum, possibly causing functional deficits. This review aims to synthesize clinical features and multidisciplinary treatment strategies for CPA tumors with brainstem involvement, emphasizing functional preservation alongside tumor control. Methods: A systematic PubMed search identified studies on VSs, CPA meningiomas, and intradural PGLs. Eligibility criteria included studies reporting tumor management and cranial nerve outcomes. Data extraction focused on tumor size, neurological presentation, surgical approach, adjunctive therapies, and postoperative cranial nerve function. Multidisciplinary involvement and rehabilitation strategies were noted. Results: Twenty studies (3311 patients) analyzed large VSs, showing facial nerve dysfunction in 8–53%, trigeminal neuropathy in 20–77%, and cerebellar signs in up to 79%. Microsurgery (MS) achieved variable gross total resection, while stereotactic radiosurgery (SRS) preserved facial nerve function but carried trigeminal and hydrocephalus risks. CPA meningiomas demonstrated cranial nerve displacement patterns critical for surgical planning, with transient deficits common and recovery linked to baseline function. In 388 intradural PGL cases, staged surgery combined with preoperative embolization was standard; functional preservation of lower cranial nerves was often limited. Across all histologies, multidisciplinary management and targeted rehabilitation were essential. Conclusions: Optimal CPA tumor management balances tumor control with functional preservation. VSs benefit from individualized MS or SRS based on size and mass effect. Meningioma surgery prioritizes cranial nerve preservation over radical resection. Intradural PGLs require staged vascular-conscious approaches. Multidisciplinary care and structured rehabilitation are pivotal to improving outcomes and quality of life.
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(This article belongs to the Special Issue Impact of Brainstem Diseases on Hearing, Balance, Speech and Swallowing)
Open AccessArticle
Impact of Hearing Aid Amplification on Subjective Tonal Tinnitus in Patients with Gently Sloping and Ski-Slope Hearing Loss: A Retrospective Cohort Study
by
Daniele Portelli, Sabrina Loteta, Cosimo Galletti, Mariangela D’Angelo, Leonard Freni, Pietro Salvago, Francesco Ciodaro and Giuseppe Alberti
Audiol. Res. 2025, 15(6), 167; https://doi.org/10.3390/audiolres15060167 - 3 Dec 2025
Abstract
Background/Objectives: This study aims to evaluate the effectiveness of hearing aid amplification in reducing self-perceived tinnitus handicap in individuals with ski-slope hearing loss—a population seldom addressed in previous research. In addition, a correlation analysis was performed to examine the relationship between tinnitus
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Background/Objectives: This study aims to evaluate the effectiveness of hearing aid amplification in reducing self-perceived tinnitus handicap in individuals with ski-slope hearing loss—a population seldom addressed in previous research. In addition, a correlation analysis was performed to examine the relationship between tinnitus duration, pitch, loudness, and THI scores. The results are then compared with those of patients with high-frequency gently sloping hearing loss. Methods: 38 patients with bilateral sensorineural hearing loss and chronic tonal tinnitus were retrospectively evaluated and divided into two equal groups: high-frequency gently sloping and ski-slope hearing loss (n = 19 each). Tinnitus pitch, loudness, and edge frequency were assessed. The Mann–Whitney test compared tinnitus characteristics between groups, while the Wilcoxon signed-rank test evaluated pre- and post-treatment THI scores. Spearman correlation was used to explore associations between tinnitus duration, intensity, pitch, and THI outcomes. Results: The Mann–Whitney test showed significant differences in tinnitus pitch, and edge frequency between both groups; no statistically significant differences were found for the tinnitus level. Tinnitus frequency was higher in the high-frequency gently sloping group. The Wilcoxon test confirmed significant improvements in THI scores post-treatment for both groups (p < 0.001). No significant correlations were found between tinnitus duration, level, pitch, and post-treatment THI scores. Conclusions: Hearing aids effectively reduce tinnitus severity in patients with ski-slope and gently sloping hearing loss, supporting their use as a therapeutic option. Larger, multicentric studies are recommended to validate these findings and explore specific auditory profiles and processing strategies.
Full article
(This article belongs to the Special Issue Emerging Technologies in Audiology: Advancing Assessment, Intervention, and Accessibility)
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Open AccessArticle
Cochlear Implants and Adult Patient Experiences, Adaptation and Challenges: A Survey
by
Sahar Bin Dehaish, Abdulmalik Bin Marouq, Abdulaziz Almalki, Medhat Yousef, Fida Almuhawas, Abdulrahman Hagr, Jad Mony, Mohammad Albaqeyah, Hala Alferaih, Haifa Alqahtani, Sara Alghuraibi, Deepthi Poovayya, Hassan Yalcouy and Dalal Alrushaydan
Audiol. Res. 2025, 15(6), 166; https://doi.org/10.3390/audiolres15060166 - 30 Nov 2025
Abstract
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Background: Cochlear implants (CIs) are a life-changing treatment for individuals with severe to profound hearing loss, yet adult CI uptake remains low despite high clinical and economic effectiveness. This study investigates adult patient experiences, adaptation, and barriers to CI access in Saudi Arabia.
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Background: Cochlear implants (CIs) are a life-changing treatment for individuals with severe to profound hearing loss, yet adult CI uptake remains low despite high clinical and economic effectiveness. This study investigates adult patient experiences, adaptation, and barriers to CI access in Saudi Arabia. Methods: A survey of 89 adult CI recipients was conducted across three major CI centers in Saudi Arabia. The electronic questionnaire explored pre- and post-implant experiences, including referral pathways, device choice, adaptation, and satisfaction. Descriptive statistics, ranked correlations, and inferential tests were used to analyze associations between demographic and clinical variables. Results: The median time between hearing loss diagnosis and implantation was 17 years, with most patients using hearing aids beforehand. Healthcare professionals were the primary source of CI interest for 48% of respondents, though younger recipients were more often influenced by peers. Longer daily device use was linked to faster acclimatization (ρ = −0.26, p < 0.05); however, age, wait time, and initial attitude did not affect adaptation. Outcomes exceeded expectations for 54% of participants. Major barriers included lack of awareness (23%) and fear of surgery (18%). Only 4% learned about CI through social media. Advice for future candidates emphasized confidence and proactive action. Conclusions: Despite expanded CI availability in Saudi Arabia, structural and societal barriers persist. Empowering healthcare professionals and utilizing social media for awareness may enhance adult CI uptake and improve hearing health outcomes.
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Open AccessArticle
Does Superior Semicircular Canal Dehiscence Surgery Resolve or Exacerbate Positional Vertigo?
by
Gerard Joseph Gianoli
Audiol. Res. 2025, 15(6), 165; https://doi.org/10.3390/audiolres15060165 - 28 Nov 2025
Abstract
Does Superior Semicircular Canal Dehiscence Surgery Resolve or Exacerbate BPPV? Background/Objectives: BPPV is commonly found to be associated with other inner ear disorders. It has been found to occur with Superior Semicircular Canal Dehiscence (SSCD) as well as postoperatively following SSCD surgical repair.
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Does Superior Semicircular Canal Dehiscence Surgery Resolve or Exacerbate BPPV? Background/Objectives: BPPV is commonly found to be associated with other inner ear disorders. It has been found to occur with Superior Semicircular Canal Dehiscence (SSCD) as well as postoperatively following SSCD surgical repair. This paper will analyze the preoperative and postoperative incidence of positional vertigo in patients undergoing SSCD surgery. Methods: This is a retrospective chart review of 50 consecutive patients with SSCD undergoing surgical repair. They were evaluated preoperatively, at 1 week postoperative, at 6 weeks postoperative, and at 12 weeks postoperative for evidence of BPPV. Information collected included demographics, the semicircular canal involved, type of BPPV, and whether the patient required canalith repositioning. Results: Preoperatively, 33 (66%) patients reported symptoms of positionally induced vertigo with confirmation during VNG testing. No patient was treated for BPPV prior to surgery. At one week postoperative, 17 (35%) patients continued to have symptoms of positionally induced vertigo; at 6 weeks postoperative, 9 (18%), and at 12 weeks postoperative, 5 (10%) patients had positional vertigo requiring canalith repositioning (p < 0.05). Three patients (6%) had no evidence of BPPV preoperatively but had positional vertigo at the one-week postoperative evaluation. At the 6-week post-op visit, only one of the patients had new-onset postoperative positional vertigo. At the 3-month visit, no patient had new-onset postoperative positional vertigo. Conclusions: BPPV and positional vertigo symptoms were found commonly prior to SSCD surgery and in the week after SSCD surgery. However, BPPV resolved by 6 weeks after SSCD surgery without additional intervention for most of these patients, while the others underwent canalith repositioning. A small percentage developed BPPV after surgery who had none preoperatively and in the contralateral ear.
Full article
(This article belongs to the Special Issue A Tribute to John M. Epley)
Open AccessArticle
Tinnitus-Related Functional and Perceptual Impairments Following COVID-19 Vaccination: An Online Multi-Domain Survey Study
by
Anusha Yellamsetty, Gianmaris Fortuna, Egbe-Etu Etu and Shaowen Bao
Audiol. Res. 2025, 15(6), 164; https://doi.org/10.3390/audiolres15060164 - 26 Nov 2025
Abstract
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Background: Tinnitus has been increasingly reported during the COVID-19 pandemic, following both infection and vaccination. While these reports suggest that pandemic-related factors may influence the onset or worsening of tinnitus, the perceptual characteristics and functional consequences of such cases remain poorly understood. This
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Background: Tinnitus has been increasingly reported during the COVID-19 pandemic, following both infection and vaccination. While these reports suggest that pandemic-related factors may influence the onset or worsening of tinnitus, the perceptual characteristics and functional consequences of such cases remain poorly understood. This study examined the nature, severity, and communication-related impact of self-reported tinnitus following COVID-19 vaccination. Methods: A total of 770 adults who self-reported new or worsened tinnitus after vaccination completed a structured online survey between August 2021 and May 2023. Standardized instruments included the Tinnitus Functional Index (TFI), the Speech, Spatial and Qualities of Hearing Scale (SSQ), and visual analog scales assessing loudness discomfort and hyperacusis-related symptoms. Analyses included descriptive statistics, chi-square tests, t-tests, and correlation matrices. Results: Respondents reported moderate to severe tinnitus-related distress, with the greatest impacts on emotional control, sleep, and relaxation. Many described communication difficulties in noisy or multi-talker environments, despite relatively preserved spatial hearing and sound quality. A substantial subset endorsed hyperacusis symptoms, including sound-induced annoyance, fear, and intolerance. Correlation analyses revealed strong associations between emotional, cognitive, and auditory domains, underscoring the multidimensional burden of tinnitus in this population. Conclusions: Self-reported tinnitus after COVID-19 vaccination was associated with distress, sleep disruption, and communication difficulties, mirroring patterns commonly observed in tinnitus more broadly. Although causality cannot be determined, these findings highlight the importance of comprehensive audiological and psychological assessment for individuals reporting auditory complaints after vaccination and support the inclusion of functional hearing outcomes in tinnitus evaluation protocols.
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Open AccessArticle
Binaural Localization Development and the Effect of SmartSound iQ with SCAN in Children with Cochlear Implants
by
Abdulaziz Alasmi, Mada Aljabr, Dalal Alrushaydan, Hassan Yalcouy and Fida Almuhawas
Audiol. Res. 2025, 15(6), 163; https://doi.org/10.3390/audiolres15060163 - 24 Nov 2025
Abstract
Background: Binaural hearing is crucial for spatial auditory perception, including sound localization. Cochlear implants (CIs) are commonly used in children with congenital deafness to support binaural auditory development, but the extent to which they facilitate effective localization remains unclear. Objective: This study evaluates
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Background: Binaural hearing is crucial for spatial auditory perception, including sound localization. Cochlear implants (CIs) are commonly used in children with congenital deafness to support binaural auditory development, but the extent to which they facilitate effective localization remains unclear. Objective: This study evaluates the impact of CIs on binaural functional auditory development and sound localization in children with congenital deafness, considering factors such as age at implantation, hearing experience, and CI laterality. Methods: Thirty-eight CI-assisted children (aged 4–9 years) underwent directional hearing assessments using the “Erfassung des Richtungshörens bei Kindern (ERKI)” device. Localization accuracy was analyzed across various noise stimuli, and correlations with audiometric parameters and CI history were examined. Results: Localization accuracy improved with age and CI experience. Bilateral CI users outperformed unilateral users, particularly with pulse pink noise stimuli. The use of SmartSound iQ with SCAN technology enhanced localization, especially in younger children. Conclusion: CIs support binaural functional auditory development in children with congenital deafness, with localization skills improving over time. Bilateral implantation and early intervention may further enhance outcomes, warranting continued research.
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(This article belongs to the Section Hearing)
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