Audiology Research

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

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

Background/Objectives: Electrocochleography (ECochG) is a promising tool to monitor preservation of cochlear structures and function during cochlear implant (CI) surgery. However, the interpretation of ECochG signal changes during insertion of the CI electrode array remains controversial. This study investigates the influence of the degree and localization of cochlear trauma on ECochG signal changes using a mouse model. Methods: C57BL/6J-Crl1 mice underwent intracochlear ECochG recordings during the insertion of a platinum–iridium electrode. Results: In case of grade 1 and 2 cochlear trauma, as determined by post-mortem histological analysis, we found that a reduction in intracochlear cochlear microphonic (CM) amplitude correlates more significantly with the location of the trauma than with its severity. The more basally a trauma is located, the larger the CM amplitude drop. Furthermore, the results revealed that grade 1 or 2 trauma was detectable through ECochG before more severe trauma developed. Conclusions: These findings suggest that intracochlear ECochG can serve as a reliable intraoperative tool for detecting early and possibly reversible cochlear trauma, preventing more severe damage and aiding hearing preservation. The results emphasize the need for a nuanced interpretation of CM signal drops, considering trauma location and cochlear structure integrity at the site of trauma and apical to it. Full article

Objectives: This systematic review aimed to evaluate the diagnostic accuracy of self-administered web- and app-based tools for audiometric testing compared to pure-tone audiometry (PTA), the clinical gold standard. Methods: Studies were eligible if they involved human participants, evaluated self-administered digital tools for audiometric testing, reported diagnostic accuracy metrics (e.g., sensitivity, specificity, and accuracy), were published between 2014 and 2024, and were written in English. Studies were excluded if they did not compare to PTA, were reviews, or did not assess self-administered tools. MEDLINE, Web of Science, Scopus, and EMBASE were systematically searched throughout November 2024. Study quality was assessed using the QUADAS-2 tool, evaluating four domains: patient selection, index test, reference standard, and flow and timing. Most studies showed some concern for a risk of bias. Results: Twelve studies, including a total of 2453 participants and evaluating 15 applications, met the inclusion criteria. The studies reported wide variability in diagnostic accuracy. Sensitivity ranged from 18% to 100%, specificity from 35.5% to 99.1%, and accuracy from 14% to 97.4%. SHOEBOX and Screenout demonstrated high diagnostic accuracy, while other apps showed inconsistent results across studies and settings. Heterogeneity in definitions of hearing loss, test environments, device and headphone types and a lack of standardized reporting limited comparability. Most studies were conducted in non-soundproof environments, and some had unclear or a high risk of bias. Conclusions: Self-administered audiometric apps and web tools show promise for remote hearing screening but require further validation and methodological standardization. Clinicians should interpret the results cautiously given the current variability in performance. Full article

Objectives: This study aimed to analyse the haematological parameters in relation to subjective tinnitus. We hypothesise that abnormal haematological findings may correlate with increased severity and chronicity of tinnitus. This research could lead to improved diagnostic methods and more targeted treatments. Material and Methods: A total of 439 patients with primary subjective tinnitus and 274 individuals without tinnitus were enrolled. These participants underwent comprehensive laboratory testing, which included haematological parameters. Results: When comparing the white blood cell levels between the tinnitus group and the control group, no statistically significant differences were found (p = 0.743). Similarly, comparisons of red blood cell levels (p = 0.250), haemoglobin levels (p = 0.087), and haematocrit levels (p = 0.066) also revealed no significant differences. The platelet levels showed no significant difference between the two groups (p = 0.782). According to a logistic regression model, lower levels of haemoglobin (p = 0.000) and platelets (p = 0.000) significantly predicted higher scores on the Tinnitus Handicap Inventory, indicating self-reported tinnitus severity. Furthermore, lower haemoglobin levels were significant predictors (p = 0.04) of developing bilateral tinnitus. Using Spearman’s correlation test, a statistically significant negative correlation (p = 0.029) was observed between red blood cell levels and the onset of tinnitus. The frequency of tinnitus demonstrated a significant positive correlation with haemoglobin levels (p = 0.04) and haematocrit levels (p = 0.043). Conversely, platelet levels showed a significant negative correlation with both tinnitus intensity (p = 0.002) and the onset of tinnitus (p = 0.033). Conclusions: While the haematological parameters showed no significant differences between the tinnitus and control groups, further analyses indicated that certain parameters, such as haemoglobin and haematocrit levels, could potentially influence tinnitus, necessitating further investigation. Full article

Background/Objectives: Vestibular dysfunction is one of the main complications after cochlear implant (CI) surgery, and there are currently no standardized protocols for vestibular assessment in CI candidates. Our objectives were to investigate the incidence of vestibular impairment after CI surgery, anamnestic (age, known systemic pathologies and cause of deafness) and surgical (intraoperative complications, malposition of the CI) risk factors, and the role of vestibular assessment in the selection of the suitable ear for implantation. Methods: We included 68 adult patients (80 ears) affected by moderate-to-profound SNHL undergoing CI. The dizziness handicap inventory (DHI), the video head impulse test (VHIT), the caloric test, and dynamic posturography (DP) were used to study the vestibular function and balance before and one month after CI. The DHI was also administered 24 h after surgery. Results: Despite significative impairment 24 h after surgery (29.6 ± 30), the mean DHI score returned to preoperative values (17.9 ± 26) after one month. Dizziness persisted in case of age ≥ 65 years old, surgical difficulties, simultaneous bilateral CI, Meniere’s disease and otosclerosis, comorbidities ≥ 3, anxiety/depression, and neurological diseases. The VHIT significantly worsened in 25% of ears, while the caloric test SPV nystagmus significantly decreased in 30% of ears. In cases of preoperative unilateral weakness, the implantation of the better ear was significantly related to higher DHI scores. Only 4/68 patients had a significant persistent reduction in the postural composite score after surgery, with an increased risk of falls. Conclusions: Medical history and vestibular assessment predict the risk of vestibular damage and help to choose the CI’s side and to manage vertigo after surgery. Full article

Objectives: Assessing balance in highly trained individuals, such as military pilots, poses challenges, as deficits may be underestimated when compared to general population norms. To address this, several studies have proposed tailored databases providing reference values for specific populations. This study retrospectively analyzed balance characteristics in active-duty military pilots of the Italian Air Force. Methods: We enrolled 106 subjects split into two groups: 53 military pilots from the Italian Air Force and 53 civilians without flight experience or exposure to specific vestibular stimuli. All participants underwent ENT examinations with audiometric testing to exclude related pathologies, followed by a personal history collection. Subsequently, they completed the EquiTest protocol across six standard conditions. Results: Significant differences were observed between Army Aviators and Non-Aviators. The PREF variable showed the most consistent distinction, with military pilots demonstrating a superior performance (p < 0.01). Additionally, borderline differences were noted in Condition 6 of the equilibrium scores (p = 0.056), and in the Centre of Gravity (COG) analysis along the X-axis for Conditions 1 and 5 (p = 0.090), and for Condition 2 (p = 0.050). These findings suggest enhanced postural control strategies among Army Aviators under conditions of sensory conflict. Conclusions: These findings suggest that normative balance values specific to military pilots should be used when evaluating aviators recovering from balance deficits. Such tailored benchmarks can help determine the need for rehabilitation before returning to duty, ensuring optimal performance under demanding conditions. Further research is necessary to explore the underlying mechanisms responsible for these adaptations and to identify the specific stimuli that contribute to the enhanced balance capabilities observed in this highly trained population. Full article

Background/Objectives: Rehabilitation success with a cochlear implant (CI) varies considerably and identifying predictive factors for the reliable prediction of speech understanding with CI remains a challenge. Hoppe and colleagues have recently described a predictive model, which was specifically based on Cochlear™ recipients with a four-frequency pure tone average (4FPTA) ≤ 80 dB HL. The aim of this retrospective study is to test the applicability to an independent patient cohort with extended inclusion criteria. Methods: The Hoppe et al. model was applied to CI recipients with varying degrees of hearing loss. Model performance was analyzed for Cochlear™ recipients with 4FPTA ≤ 80 dB HL and for all recipients regardless of 4FPTA. Subgroup analyses were conducted by WRS_max and CI manufacturer. Results: The model yielded comparable results in our patient cohort when the original inclusion criteria were met (n = 24). Extending the model to patients with profound hearing loss (4FPTA > 80 dB HL; n = 238) resulted in a weaker but significant correlation (r = 0.273; p < 0.0001) between predicted and measured word recognition score at 65 dB with CI (WRS₆₅(CI)). Also, a higher percentage of data points deviated by more than 20 pp, either better or worse. When patients provided with CIs from different manufacturers were enrolled, the prediction error was also higher than in the original cohort. In Cochlear™ recipients with a maximum word recognition score (WRS_max) > 0% (n = 83), we found a moderate correlation between measured and predicted scores (r = 0.3274; p = 0.0025). Conclusions: In conclusion, as long as the same inclusion criteria are used, the Hoppe et al. (2021) prediction model results in similar prediction success in our cohort, and thus seems applicable independently of the cohort used. Nevertheless, it has limitations when applied to a broader and more diverse patient cohort. Our data suggest that the model would benefit from adaptations for broader clinical use, as the model lacks sufficient sensitivity in identifying poor performers. Full article

Background/Objectives: This study examined the effect of sound preference on loudness tolerance (LTLs) and preferred listening levels (PLLs) using personal listening devices (PLDs). The implication of this relationship on hearing health promotion counseling and practices using PLDs is discussed. Methods: Participants were 50 individuals, aged 21 to 90 years, with normal hearing or hearing loss. Listeners rated several sound samples (i.e., music, running speech, and machinery noise) played through a PLD using earphones according to their sound preference (i.e., enjoyable, acceptable, and unpleasant) and then self-adjusted the volume setting to their LTL and PLL for a sound sample in each sound preference category. Results: Most listeners judged music (70%) as enjoyable, running speech (54%) as acceptable, and machinery noise (84%) as unpleasant. No significant differences were found in LTLs according to sound preference, but PLLs for enjoyable sounds occurred at significantly higher levels compared with those deemed acceptable or unpleasant. Conclusions: Listeners using PLDs perceived LTLs and PLLs differently according to their sound preferences. PLLs occurred at significantly higher volumes for sounds deemed enjoyable when using PLDs. The implication is that hearing health counseling should include information to PLD users on the potential of altered loudness perception with enjoyable sounds, which may lead to higher and riskier PLD listening levels. Full article

Objective: To evaluate the feasibility of vestibular screening in infants and investigate age-related changes in the characteristics of air-conducted sound cervical vestibular evoked myogenic potential (ACS-cVEMP) and bone-conducted vibration cervical vestibular evoked myogenic potential (BCV-cVEMP) in infants and children with normal hearing, aiming to provide new insights into the developmental trajectory of vestibular function during early childhood. Methods: A total of 159 subjects aged 3 months to 17 years old were divided into seven age groups. Additionally, 20 adults aged 18–30 years were included as controls to explore developmental changes in the sacculocollic reflex pathway. Results: The response rates of BCV-cVEMP in 3-month-olds were significantly higher than that of ACS-cVEMP (p = 0.048), while no significant difference was observed in other age groups (p > 0.05). Age-related changes were found in both latencies and amplitudes of ACS-cVEMP and BCV-cVEMP. ACS-cVEMP latencies reached adult levels at 13–17 years, while BCV-cVEMP latencies normalized by 7–12 years. ACS-cVEMP amplitudes increased with age, stabilizing at 4 years, whereas BCV-cVEMP amplitudes peaked at 4–6 years before gradually decreasing. Conclusions: This study demonstrates that cVEMP is not only a viable tool for vestibular screening in infants but also reveals crucial age-related developmental changes in the vestibular system. These findings contribute new insights into the maturation of the vestibular reflex pathways and provide normative data that can be used to guide early vestibular screening practices. Full article

Background/Objectives: with the aim of describing how students and their teachers perceive and define their hearing and auditory experience in the classroom, we present the results of a questionnaire that examined the listening challenges faced by students and teachers at the University of Perugia and in four secondary schools in Friuli-Venezia Giulia, Italy. Methods: A survey was developed as part of the A.Ba.Co. project (Overcoming Communication Barriers). Closed or open-ended questions were used to analyze the responses of students and teachers regarding diagnosed or only perceived hearing difficulties in daily life and the quality of listening in school classes. Results: Hearing difficulties, either clinically diagnosed or only perceived, were reported by 8–9% of students. Between teachers, the reported hearing difficulties were 27.1% in high school and 12% at university (p < 0.001). The most frequent reason for less-than-optimal ease of listening in class differed between the two educational levels; 45.8% of high school students blamed it on the noise in the room compared to 18.2% of university students (p < 0.001). Inversely, 40.9% of university students connected listening difficulty with their place in class compared to 9.5% (101/1065) of high school students (p < 0.001). Conclusions: Although the minimum acoustic requirements for educational facilities have been established by the UNI 11532-2 standard, it is speculated that the majority of high school and university classrooms in Italy do not meet optimal listening conditions. Furthermore, the reasons for students’ poor listening quality appear to not be fully understood, neither by students nor by teachers. In addition to the need for greater attention to physical learning spaces (advocating the universal design principles), effective change will also need to involve a greater awareness of what the barriers to listening are and how much they influence both teaching and learning quality and effectiveness. Full article

Background/Objectives: As vestibular paroxysmia (VP) has recently been described in children, with an incidence of up to 4% of vertigo, and a promising therapeutic response to sodium-channel-blocking drugs has also been reported, the aim of this paper is to review the available literature on this topic and to provide the best possible guidance for diagnosis and treatment. Methods: PubMed, Medline, Cochrane, and Crossref databases were searched, and all studies on VP in children and sodium channel blockers were selected. Results: Only five articles reporting small case series or single case reports were identified. To date, oxcarbazepine (OXC) and carbamazepine (CBZ) are the only two molecules prescribed. The recommended doses were 300 to 360 mg/day and 50 to 200 mg/day for OXC and CBZ, respectively, for a total duration of 6 weeks. Fast efficacy (one week) was reported. Conclusions: VP has been identified in pediatric patients and appears to respond to sodium channel blockers in a manner similar to adults. Only a limited number of cases have been reported to date; thus, there is a need to raise awareness about this treatable cause of episodic vertigo in children. Full article

Background/Objectives: Subterranean mole-rats live in an intricate system of underground tunnels, a unique acoustic environment that has led to adaptations to their hearing. Most experimenters have concluded that mole-rats have poor hearing thresholds, perhaps 20–40 dB less sensitive than rodents living on the surface. The potential problem identified here is that mole-rat thresholds have all been measured in air, whereas there is some evidence—theoretical and observational—to suggest that these animals may hear more sensitively via bone conduction. Methods: A wide-ranging review of the literature surrounding mole-rat hearing is undertaken and then interpreted in terms of the ways air conduction and bone conduction thresholds are measured. The important factor, often overlooked, is that the detection of an acoustic signal is most sensitive when there are matching impedances all along the transmission path, and the argument is made that, for subterranean mole-rats, more energy may be transmitted to their cochlea when the head is directly in contact with the earth than when an acoustic signal must propagate from the earth to the air and then reach the cochlea via the external and middle ear. Results: Based on observational evidence, theoretical considerations, and inferences from related species, the suggestion is made that, for African mole-rats, high bone conduction sensitivity could make up for their relatively poor air conduction thresholds. Conclusions: Bone conduction audiograms are needed for mole-rats, similar to those for other animals sensitive to substrate vibration such as snakes or amphibians. It is possible that the hearing thresholds of mole-rats may, when measured appropriately, be comparable to those of other rodents. Full article

Introduction: Masseter vestibular evoked myogenic potentials (M-VEMPs) are a recent tool for assessing a vestibulo-trigeminal pathway departing from the saccule, similarly to cervical VEMPs (C-VEMPs), that evaluate saccular function via the sternocleidomastoid muscle. M-VEMPs may offer a complementary diagnostic value in vestibular neuritis (VN). Methods: This retrospective study analysed M-VEMPs and C-VEMPs in 28 monolateral patients and 1 bilateral (30 ears) diagnosed with VN between 2023 and 2024. Diagnostic evaluation included video head impulse tests (VHIT), caloric tests, ocular VEMPs, and, in a few cases, electromyography (EMG) of the sternocleidomastoid muscle. M-VEMPs were elicited using 500 Hz tone bursts at 97 dB nHL. Results were compared based on the topography of vestibular involvement and muscle response concordance. Results: M-VEMPs were always present in patients with superior VN and intact saccular function, showing consistent results with normal C-VEMPs. In some cases, with saccular dysfunction, M-VEMPs were preserved despite the absence of C-VEMPs, suggesting greater robustness. One patient with herpes zoster (HZ) involving both the VIII and trigeminal nerves showed absent M-VEMPs, indicating trigeminal pathway involvement. Edentulous patients showed reduced or absent M-VEMPs due to compromised masseter muscle electromyography activity. Conclusions: M-VEMPs are reliable and often concordant with C-VEMPs in VN but may reveal additional diagnostic information in discordant or complex cases. They are particularly useful in identifying trigeminal involvement but are limited in patients with poor masseter muscle function. Further studies are needed to clarify their full diagnostic potential. Full article

Background/Objectives: Hearing loss represents an important communication barrier which can lead to social isolation and can be a challenge for mental health status. It is generally accepted that hearing aid (HA) users can develop a stigma related to hearing loss despite the perceived benefits due to most modern technologies. Nevertheless, stigma toward HAs may persist even when patients have been well acclimatized to their use. This study aims to evaluate their experiences in everyday life, the underlying social aspects and the utility of psychometric multidimensional approach in skilled HA users. Methods: In total, 96 HA users and 85 normally hearing subjects were enrolled and asked to complete three psychometric questionnaires that investigated social functioning, body image perception, and psychological distress. HA users were additionally asked to fulfill a disease-specific survey, the International Outcome Inventory for Hearing Aids. The performance of the devices was also investigated by HA’s functional gain through free-field audiometry. Results: Even if auditory devices help with compensating the sensorial deprivation, patients often suffer from social anxiety, social phobia and body image concerns about their appearance while wearing HAs. Conclusions: This study discloses psychopathological factors associated with the HA experience that are surprisingly present after long satisfying HA use. Despite the benefits, the satisfaction and the daily use, HA users continue to be worried about body image and report more psychopathological distress in comparison to their normal hearing peers. Full article

Vestibular atelectasis (VA) is a rare clinical entity characterized by a collapse of the endolymphatic space resulting in vestibular loss with the possible onset of positional and/or sound/pressure-induced vertigo. It could be idiopathic or secondary to other inner-ear diseases including Meniere’s disease (MD). A collapse of the membranous labyrinth involving the semicircular canals (SCs) and the utricle represents its distinctive histopathological feature. While specific radiological patterns consistent with VA have been described on contrast-enhanced MRI with delayed acquisitions, an impairment of the blood–labyrinthine barrier (BLB) could be detected in several disorders leading to vestibular loss. We conducted a narrative review of the literature on VA focusing on the putative pathomechanisms accounting for positional and sound/pressure-induced nystagmus despite unilateral vestibular loss (UVL) in this condition, providing two novel cases of VA. Both patients presented with a clinical picture consistent with unilateral MD that rapidly turned into progressive UVL and positional and/or sound/pressure-induced vertigo. In both cases, the posterior SC was initially impaired at the video-head impulse test (vHIT) and both cervical and ocular VEMPs were initially reduced. Progressively, they developed unsteadiness with paretic spontaneous nystagmus, an impairment also for the lateral and anterior SCs, caloric hypo/areflexia and VEMPs areflexia. They both exhibited ipsilesional nystagmus to sound/pressure stimuli and in one case a persistent geotropic direction-changing positional nystagmus consistent with a “light cupula” mechanism involving the lateral SC of the affected side. A collapse of the membranous labyrinthine walls resulting in contact between the vestibular sensors and the stapes footplate could explain the onset of nystagmus to loud sounds and/or pressure changes despite no responses to high- and low-frequency inputs as detected by caloric irrigations, vHIT and VEMPs. On the other hand, the onset of positional nystagmus despite UVL could be explained with the theory of the “floating labyrinth”. Both patients received contrast-enhanced brain MRI with delayed acquisition exhibiting increased contrast uptake in the pars superior of the labyrinth, suggesting an impairment of the BLB likely resulting in secondary VA. A small intralabyrinthine schwannoma was detected in one case. VA should always be considered in case of positional and/or sound/pressure-induced vertigo despite UVL. Full article

Background: Auditory steady-state responses (ASSRs) are sustained potentials used to assess the physiological integrity of the auditory pathway and objectively estimate hearing thresholds. ASSRs are typically analyzed using statistical procedures to remove the subjective bias of human operators. Knowing when to terminate signal averaging in ASSR testing is critical for making efficient clinical decisions and obtaining high-quality data in empirical research. Here, we report on stimulus-specific (frequency, level) properties and operating ranges of a novel ASSR detection metric based on mutual information (MI). Methods: ASSRs were measured in n = 10 normal-hearing listeners exposed to various stimuli varying in modulation rate (40, 80 Hz) and level (80–20 dB SPL). Results: MI-based classifiers applied to ASSR recordings showed that the accuracy of ASSR detection ranged from ~75 to 99% and was better for 40 compared to 80 Hz responses and for higher compared to lower stimulus levels. Receiver operating characteristics (ROCs) were used to establish normative ranges for MI for reliable ASSR detection across levels and rates (MI = 0.9–1.6). Relative to current statistics for ASSR identification (F-test), MI was a more efficient metric for determining the stopping criterion for signal averaging. Conclusions: Our results confirm that MI can be applied across a broad range of ASSR stimuli and might offer improvements to conventional objective techniques for ASSR detection. Full article

Background/Objectives: Previous research has shown that listeners may use acoustic cues for speech processing that are perceived during brief segments in the noise when there is an optimal signal-to-noise ratio (SNR). This “glimpsing” effect requires higher cognitive skills than the speech tasks used in typical audiometric evaluations. Purpose: The aim of this study was to investigate the use of an online test of speech processing in noise in listeners with typical hearing sensitivity (TH, defined as thresholds ≤ 25 dB HL) who were asked to determine the gender of the subject in sentences that were presented in increasing levels of continuous and interrupted noise. Methods: This was a repeated-measures design with three factors (SNR, noise type, and syntactic complexity). Study Sample: Participants with self-reported TH (N = 153, ages 18–39 years, mean age = 20.7 years) who passed an online hearing screening were invited to complete an online questionnaire. Data Collection and Analysis: Participants completed a sentence recognition task under four SNRs (−6, −9, −12, and −15 dB), two syntactic complexity settings (subjective-relative and objective-relative center-embedded), and two noise types (interrupted and continuous). They were asked to listen to 64 sentences through their own headphones/earphones that were presented in an online format at a user-selected comfortable listening level. Their task was to identify the gender of the person performing the action in each sentence. Results: Significant main effects of all three factors as well as the SNR by noise-type two-way interaction were identified (p < 0.05). This interaction indicated that the effect of SNR on sentence comprehension was more pronounced in the continuous noise compared to the interrupted noise condition. Conclusions: Listeners with self-reported TH benefited from the glimpsing effect in the interrupted noise even under low SNRs (i.e., −15 dB). The evaluation of glimpsing may be a sensitive measure of auditory processing beyond the traditional word recognition used in clinical evaluations in persons who report hearing challenges and may hold promise for the development of auditory training programs. Full article

Objectives: This study investigates Greek teenagers’ general knowledge and perception of hearing loss, hearing aid accessibility, and the challenges associated with hearing impairment. Methods: A 27-item self-reported questionnaire was developed and distributed to 152 participants (aged 12–18) to assess their familiarity with hearing loss, amplification availability, communication strategies, and perceptions of hearing loss. Results: While 94.7% of participants recognized that hearing loss affects communication, only 10.5% correctly identified how hearing aids are accessed. Additionally, 42.1% reported having temporarily experienced some form of hearing loss. Most participants (94.7%) acknowledged communication difficulties faced by individuals with hearing loss, and only 3.4% reported being unable to communicate effectively with someone affected. Among those aware of bullying incidents involving individuals with hearing loss, 78.1% identified classmates as the primary source. Conclusions: These findings are consistent with international research and highlight the need for targeted education, awareness initiatives, and clearer access pathways to hearing technology. Improving adolescent hearing health literacy may facilitate early intervention, reduce stigma, and promote inclusion for peers affected by hearing impairment. Full article