Audiology Research

Purpose: This study aimed to map publication trends, topical focus, study designs, and institutional concentration in otology research in Saudi Arabia from 1978 to 2024 to deduce any topical, regional, institutional, or funding disparities in the field of otology in the country. Methods: We conducted a scoping review of studies on human ear diseases in Saudi Arabia, searching PubMed and the Cochrane Library from inception to 31 December 2024. Bibliometric characteristics were charted, topics were mapped to ICD-11 chapters, and temporal trends were modelled using negative binomial regression with a single data-driven breakpoint. Results: Of 2227 records identified, 510 studies were included. Annual output increased by 9.28% (95% CI 7.05–11.55). An inflection occurred around 2017, with slower growth before 2017 (7.2%/year, 95% CI 5.3–9.1) and faster growth from 2018 onward (23.9%/year, 95% CI 18.6–29.4). The institutional affiliation of first authors was concentrated in a small number of organizations, led by King Saud University. Observational studies predominated (441/510), whereas experimental studies were limited (16/510). ICD-11 mapping showed the greatest concentration in “Ear and mastoid” (189/510, 37.1%) and “Factors influencing health status or contact with health services” (179/510, 35.1%) chapters. Funding was reported in 75 studies. Conclusions: PubMed- and Cochrane-indexed otology and hearing health research output in Saudi Arabia has grown substantially, particularly since 2017, but remains concentrated by institution, region, study design, and topic. The dominance of cochlear implant and hearing impairment research, together with limited multicenter, experimental, vestibular, tinnitus, and rehabilitation-focused studies, identifies priorities for future audiology and neurotology research planning. Full article

Background/Objectives: Recurrent acute otitis media (AOM) in children is known to cause cumulative cochlear and vestibular injury. Whether a single fulminant episode severe enough to require surgical intervention produces an analogous long-term audiovestibular signature, and whether infection severity contributes to outcome independently of cumulative episode count, is unclear. The present study addressed this gap. Methods: In this single-centre retrospective cohort study, 65 paediatric patients who had undergone surgical treatment for acute mastoiditis—the fulminant form of AOM—between July 2001 and March 2021 were assessed a median of 11.5 years after surgery. Of these, 35 had undergone mastoidectomy with tympanostomy and 30 had undergone tympanostomy alone because their episode had not been severe enough to require mastoidectomy. Thirty-two age-matched healthy volunteers (one ear each) formed the control group, yielding 97 ears in three groups (Group TM, 35 ears; Group T, 30 ears; Group C, 32 ears). Extended high-frequency pure-tone audiometry (125–20 kHz), distortion-product otoacoustic emissions (DPOAEs), single-frequency and wideband tympanometry, ipsilateral acoustic reflex thresholds, and lateral-canal vestibulo-ocular reflex gain were measured. Results: Both operated groups showed significantly elevated audiometric thresholds in the high- and extended high-frequency ranges compared with controls (HTA: χ² = 24.25, p < 0.001), with corresponding reductions in DPOAE amplitudes (HTA: χ² = 25.04, p < 0.001). Group TM did not differ significantly from Group T at any frequency band, indicating a negligible additional contribution of mastoidectomy itself. Acoustic reflex thresholds were elevated in Group TM. Vestibulo-ocular reflex gain was within reference ranges in all groups. Conclusions: A single fulminant episode of acute middle-ear infection in childhood—whether severe enough to require mastoidectomy or treated by tympanostomy alone—was associated, more than a decade later, with significantly elevated audiometric thresholds closely resembling those reported after multiple recurrent infections, supporting an effect of infection severity independent of cumulative episode count. Long-term audiological follow-up with extended high-frequency audiometry and otoacoustic emission testing is warranted, irrespective of whether mastoidectomy was required. Full article

Introduction: Teprotumumab (Tepezza^®), an insulin-like growth factor-1 receptor (IGF-1R) antagonist, is the first FDA-approved targeted therapy for thyroid eye disease (TED). While effective for reducing proptosis and inflammation, increasing post-marketing evidence has linked teprotumumab to auditory adverse events. IGF-1 signaling is essential for cochlear maintenance and neuroprotection; therefore, systemic IGF-1R inhibition presents a biologically plausible mechanism for ototoxicity. Despite growing recognition of these effects, no standardized approach exists for audiologic assessment or monitoring of patients receiving teprotumumab. This review aimed to (1) summarize proposed mechanisms and the reported spectrum of teprotumumab-related auditory effects, (2) evaluate current methods used to assess and monitor these patients, and (3) identify areas of consensus and ongoing uncertainty. Methods: An updated narrative review of the literature was conducting using PubMed, CINAHL, and Google Scholar using Boolean strings targeting teprotumumab exposure and hearing-related outcomes. Studies from 2022 onward were identified using Boolean search strings targeting teprotumumab exposure and hearing-related outcomes. Peer-reviewed English language studies reporting audiometric findings were eligible for inclusion. Results: Ten studies met inclusion criteria. Reported effects most commonly included bilateral high-frequency SNHL, tinnitus, and aural fullness, typically emerging after three to six infusions. Many cases demonstrated persistent deficits despite drug discontinuation. Baseline audiometric assessment was not uniformly reported across studies, and monitoring protocols varied considerably, with inconsistent incorporation of speech testing and immittance measures. Conclusions: Teprotumumab-associated ototoxicity is increasingly recognized and potentially irreversible. Current evidence is insufficient to guide standardized monitoring. Prospective studies are urgently needed to establish evidence-based audiologic surveillance protocols. Full article

Background/Objectives: Sensorineural hearing loss (SNHL) is a chronic condition with no established pharmacological treatment. Recent advances in drug-based therapies offer promising opportunities to prevent or treat SNHL. This scoping review summarizes the current landscape of pharmacotherapeutics for SNHL. Methods: This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A literature search of PubMed, Google Scholar, Embase, Scopus, and Web of Science was conducted in 2024 using keywords related to SNHL and pharmacotherapeutics. A review protocol was preregistered on the Open Science Framework. A systematic search of five electronic databases identified published studies from 2004 to 2024 on pharmacological treatments for SNHL in human participants, as well as ongoing clinical trials. Interventions were categorized by mechanism of action: antioxidant therapy, steroid-based combination therapy, hematologic-based therapy, pathway modulator therapy, regenerative therapy, and gene therapy. A narrative synthesis approach was used to map key trends across treatment types, study designs, and outcomes. Results: Sixty-six records met the inclusion criteria, including 48 published studies and 18 ongoing or recently completed clinical trial records. Antioxidants, corticosteroids, hematologic agents, and pathway modulators have demonstrated potential in preventing or treating SNHL caused by cisplatin, aminoglycosides, noise-induced ototoxicity, and intraoperative cochlear implantation trauma. Emerging regenerative and gene therapies show promise as future pharmacologic treatment options. Conclusions: Pharmacologic therapies for SNHL are promising but remain constrained by small sample sizes, heterogeneous study designs, and drug delivery challenges across the blood–labyrinth barrier. Future research should prioritize multicenter randomized trials, optimized delivery strategies, and integration of precision medicine approaches. Full article

Background/Objectives: Tinnitus is a prevalent auditory condition associated with significant psychological burden and limited treatment efficacy. While physical activity confers broad health benefits, its relationship with tinnitus remains understudied. This study examined associations between domain-specific physical activity and tinnitus in a nationally representative sample of U.S. adults. Methods: Data from NHANES 2015–2018 were analyzed. The final analytic sample comprised 4301 adults aged 20 years and older. Tinnitus was assessed via the NHANES audiometry questionnaire. Physical activity was categorized as low, moderate, and high (MET-min/week) separately for work-related (WORK) and non-work-related (NW) domains. Survey-weighted multivariable logistic regression models, adjusted for age, sex, race, BMI, poverty–income ratio, sedentary time, smoking, education, noise exposure, hypertension, diabetes, and depressive symptoms, were used to examine associations. Linear trends across ordered physical activity categories were evaluated using ordinal trend analyses. Results: The weighted prevalence of tinnitus was 17.3%. High NW physical activity (PA) was associated with significantly lower odds of tinnitus (OR = 0.70, 95% CI: 0.488–0.995, p = 0.0475), while high WORK PA was associated with significantly higher odds (OR = 1.30, 95% CI: 1.06–1.60, p = 0.018). Trend analyses confirmed opposing linear trends across ordered categories: inverse for NW PA (OR = 0.83 per category, p-trend = 0.0406) and positive for WORK PA (OR = 1.14 per category, p-trend = 0.017). Noise exposure and depressive symptoms were independently associated with tinnitus across both models. Conclusions: These findings suggest a domain-specific paradox: NW PA was associated with lower odds of tinnitus, whereas WORK PA was associated with higher odds. These results highlight the importance of domain-specific assessment and identify recreational activity as a potential modifiable factor warranting further investigation. Given the cross-sectional design, these associations should not be interpreted as causal. Full article

Background/Objectives: Auditory neuropathy spectrum disorder (ANSD) is a well-established hearing disorder in the pediatric population and is estimated to account for at least 10% of children with sensorineural hearing loss. Compared to auditory function, vestibular function in children with ANSD has not been well described in the past. The purpose of this study is to examine vestibular testing results in children with ANSD and to better characterize vestibular dysfunction in these children. Methods: A retrospective review of vestibular laboratory testing results was conducted in pediatric patients diagnosed with ANSD. Vestibular evaluation included vestibular evoked myogenic potential (VEMP), rotary chair test, video head impulse test (vHIT), and videonystagmography (VNG). Results: A total of 30 pediatric patients with ANSD were identified, including 18 boys and 12 girls, with a mean age of 4.5 years. Bilateral ANSD was found in 24 cases, while 6 cases were unilateral. Etiologies of ANSD included a history of hyperbilirubinemia in infancy, cochlear nerve dysplasia, genetic-related conditions, etc. Vestibular dysfunction was found in 12 cases, as indicated by at least one abnormal outcome in VEMP, vHIT, or rotary chair testing. Nineteen children were cochlear implant candidates and eventually underwent unilateral or bilateral implantation. Conclusions: Vestibular dysfunction is significant in pediatric patients with ANSD, and vestibular outcomes appear to be related to underlying etiologies. Formal vestibular evaluation is necessary to identify such vestibular losses, and these findings will be helpful to guide clinical management and rehabilitation strategies for these children. Full article

Background: Hearing loss is highly prevalent among older adults and represents a growing public health burden. Increasing attention has been given to the associations between hearing loss, cognitive decline, and dementia risk. Cochlear implantation is an established intervention for adults with severe-to-profound sensorineural hearing loss who obtain limited benefit from conventional amplification, but its potential cognitive effects remain debated. Objective: This narrative review summarizes current evidence on cognitive outcomes after cochlear implantation in adults and older adults, with particular attention to cognitive domains, long-term trajectories, methodological limitations, and clinical implications. Main findings: Available evidence suggests that cochlear implantation may be associated with improvement or stabilization of selected cognitive domains, particularly attention, executive function, working memory, and memory. However, findings are heterogeneous across studies, cognitive tools, and follow-up durations. Prospective longitudinal studies using hearing-adapted or visually presented cognitive batteries support the possibility of postoperative cognitive benefit, but the magnitude and durability of this effect vary between individuals and domains. Long-term studies suggest that cognitive improvement may be strongest during the first postoperative years and may later stabilize or attenuate, whereas auditory and quality-of-life benefits appear more consistently sustained. Conclusions: Cochlear implantation should be regarded as an established hearing rehabilitation strategy with robust benefits for auditory performance and quality of life, and as a potentially cognition-supportive intervention in selected older adults with severe-to-profound hearing loss. Current evidence does not yet prove that cochlear implantation prevents dementia. Future studies should use standardized hearing-adapted cognitive protocols, longer follow-up, adequate comparison groups, and clinically meaningful cognitive endpoints. Full article

Background/Objectives: The present study aimed to verify the importance of different components of aural rehabilitation and evaluate their relevance and acceptability among the Kannada-speaking population in India. This evaluation is intended to inform the development of a tailored aural rehabilitation module for this population. Methods: A thorough literature review was conducted to gain insights into the components of aural rehabilitation in the Western context. The insights gathered from this review served as foundational information for a focus group discussion. The focus group discussion consisted of 15 participants, including audiologists, adults with hearing loss, and their significant others. The data were transcribed and analyzed using inductive thematic analysis. Results: The audiologists in our study confirmed that the components of aural rehabilitation presented in the literature are essential, including sensory management, informational counseling, perceptual training, and personal adjustment counseling. Perspectives of significant others are the highlight of this study as they are less explored in the context of aural rehabilitation in India. Other themes identified from the FGDs included the involvement of family, the impact of hearing loss, awareness of various management options, and challenges/barriers related to aural rehabilitation. Furthermore, most of the adults with hearing loss and their significant others primarily viewed hearing aids as the sole solution. Conclusions: This study highlights the importance of a comprehensive aural rehabilitation program for adults with hearing loss and their significant others in the Kannada speaking population. It emphasizes the importance of informational counseling, communication strategies, and psychosocial support. Involving significant others might foster understanding and support, aiding in the acceptance of hearing loss and its rehabilitation, ultimately improving everyday communication and addressing functional challenges. Full article

Background/Objectives: Hearing loss is a leading cause of disability worldwide, with speech perception representing a key functional outcome of auditory rehabilitation. While hearing aids improve audibility, outcomes vary substantially across clinical subgroups. This study aimed to compare speech perception outcomes after hearing aid fitting in adults with conductive and sensorineural hearing loss and to identify determinants of variability in rehabilitation outcomes. Methods: This prospective longitudinal observational study included 250 adults with clinically confirmed bilateral conductive or sensorineural hearing loss who underwent standardized audiological assessment, bilateral hearing-aid fitting, immediate post-fitting evaluation, and 3-month follow-up in Kazakhstan between January 2023 and December 2024. Participants were classified as having conductive (n = 100) or sensorineural hearing loss (n = 150) based on audiometric criteria. Speech perception was assessed using a Kazakh-language open-set speech audiometry test. Multivariable linear regression models were used to estimate differences in 3-month aided speech perception after adjustment for the corresponding immediate post-fitting aided score and prespecified demographic, clinical, and audiometric covariates. Linear mixed-effects models were used separately to assess change in aided speech perception from immediate post-fitting to 3 months and to test whether this change differed by hearing-loss type. Propensity score matching was performed as a secondary sensitivity analysis. Results: Patients with conductive hearing loss demonstrated consistently higher speech perception scores than those with sensorineural hearing loss across all conditions. At 3 months, adjusted analyses showed no significant difference between groups for aided speech perception in quiet at 60 dB SPL, whereas sensorineural hearing loss remained associated with lower aided speech perception in noise at 60 dB SPL with SNR +3 dB (β = −1.73; 95% CI: −3.10 to −0.36; p = 0.014). In mixed-effects models assessing repeated aided scores from immediate post-fitting to 3 months, sensorineural hearing loss was associated with lower overall aided speech perception in both quiet and noise conditions. A modest improvement over time was observed only for speech perception in noise, and the group-by-time interaction was not statistically significant. Increasing age, higher tonal thresholds, advanced hearing loss stage, and living alone were independently associated with poorer outcomes. Conclusions: Aided speech perception scores were high after hearing-aid fitting in both conductive and sensorineural hearing loss; however, patients with sensorineural hearing loss showed persistently poorer outcomes, particularly in noise. These findings highlight the importance of incorporating speech-in-noise assessment and addressing clinical and social determinants to support hearing rehabilitation. Full article

Background and Aims: Accuracy in speech perception in bilingual children is influenced by two phonological systems. This study compares phonological development in bilingual Urdu–English (UE) children with CIs with their hearing-age-matched peers with normal hearing (NH), by investigating whether bilingualism or any spectral limitations of CI impact perception of UE phonemes. Method and Procedures: Children (n = 57) aged 3; 0–6; 11 years (28 CI, 29 NH) were assessed for speech perception using a custom-designed UE Speech Perception Test (UE-SPT), in quiet and noise (+5 dB SNR). Responses were analysed using confusion matrices, across phonological parameters of place, manner, and voicing to determine error patterns. Outcomes and Results: Significant deficits in CI children were found across all features, with voicing discrimination showing the largest errors (effect sizes d > 6), exacerbated by noise, especially for Urdu aspirated stops. CIs mastered only 8.3% Urdu-aspirated consonants at 6; 11 years compared to 91.7% mastered by NH peers, indicating critical language-specific vulnerabilities. Backing and substitutions errors were particularly seen in CI’s speech, whilst manner was preserved. Conclusion and Implications: UE bilingual phonological complexity compounded by inadequate speech processing abilities in CIs challenges them, underscoring urgent need for targeted speech therapy interventions focusing voicing contrasts and aspirated consonants, as well as environmental accommodations that reduce noise interference and enhance listening through CI, to optimise educational outcomes. This research contributes vital clinical guidance for supporting bilingual children with cochlear implants, addressing both environmental, technological and linguistic challenges. Full article

Background/Objectives: This study investigated auditory perception and psychosocial well-being in long-term cochlear implant (CI) users, with a particular focus on the effects of auditory (re)habilitation on learned helplessness and speech-in-noise perception, representing everyday listening performance. Methods: Thirty CI users and thirty peers with typical hearing (TH) participated in the study. Speech perception was assessed using the Hearing in Noise Test (HINT) and the Matrix Test in both quiet and noisy listening conditions. Psychosocial status was evaluated using the Learned Helplessness Scale (LHS), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Perceived hearing quality was evaluated using the Hearing Implant Sound Quality Index (HISQUI). Results: CI users showed significantly poorer speech perception performance than TH participants (p < 0.05), whereas between-group psychosocial outcomes, including LHS, BDI, and BAI scores, did not differ significantly (p > 0.05). Positive correlations were observed between Matrix and HINT scores in quiet and noisy conditions. Positive associations were also observed between CI hearing thresholds and HINT/Matrix results in noisy conditions. Within the prelingually deaf CI subgroup, age at implantation was correlated with CI thresholds, as well as with speech perception performance across both tests (p < 0.05). Conclusions: Although CI users showed significantly poorer speech perception performance, their levels of learned helplessness, depression, and anxiety were comparable to those of their TH peers. These results suggest auditory benefits following long-term CI rehabilitation, while psychosocial status appears to be within a typical range despite persistent listening difficulties in daily life. Full article

Background/Objectives: Vestibular migraine is a common but often underrecognized cause of dizziness in otolaryngology practice. Although awareness has increased, variation in clinician training and management may contribute to inconsistent care. This study evaluated current diagnostic and treatment practices of Canadian otolaryngologists for vestibular migraine, including familiarity with diagnostic criteria, therapeutic approaches, perceived barriers, and educational needs. Methods: A national cross-sectional electronic survey was distributed to practicing and emeritus members of the Canadian Society of Otolaryngology–Head and Neck Surgery from February to April 2025. The 14-item survey assessed demographics, clinical exposure to dizzy patients, residency training, diagnostic familiarity, treatment patterns, referral practices, barriers to care, and preferred educational resources. Responses were anonymized and analyzed using descriptive statistics. Results: Forty-four otolaryngologists completed the survey (response rate: 7.4%). Most respondents reported being very familiar (59.1%) or moderately familiar (38.6%) with vestibular migraine diagnostic criteria, and 97.7% reported currently diagnosing and/or treating these patients. However, only 15.9% had received extensive residency training specific to migraine or vestibular migraine. Common treatments included lifestyle and dietary modification (90.9%), nutraceutical supplements (59.1%), tricyclic antidepressants (54.5%), and analgesics (52.3%). Vestibular rehabilitation therapy (29.5%) and calcitonin gene-related peptide-targeted therapies (<10%) were used less frequently. Major barriers were clinical time constraints (65.9%), lack of training or knowledge (54.5%), and diagnostic complexity (47.7%). Clinical guidelines (70.5%) and continuing medical education courses (65.9%) were identified as the most valuable supports. Conclusions: Among surveyed Canadian otolaryngologists engaged in dizziness and vestibular migraine care, substantial heterogeneity existed in training and management practices. Standardized guidance, enhanced education, and interdisciplinary collaboration may improve consistency of care and patient outcomes. Full article

Presbycusis, or age-related hearing loss (ARHL), is a multifactorial disorder characterized by a gradual, bilateral sensorineural decline in hearing sensitivity, predominantly affecting high-frequency sounds. It is one of the most common chronic conditions in the aging population and represents a major public health concern due to its high prevalence and progressive nature. Presbycusis significantly impairs speech perception, especially in noisy environments, leading to communication difficulties, reduced social participation, increased risk of social isolation, and a decline in quality of life. Moreover, growing evidence highlights a strong association between ARHL and cognitive impairment, dementia, depression, and increased frailty in older adults. The etiology of presbycusis is complex and involves the interplay between genetic predisposition and cumulative environmental and lifestyle-related factors. Genetic susceptibility influences cochlear aging, neural degeneration, and vulnerability to external insults. Non-genetic contributors include chronic noise exposure, cardiovascular and metabolic disorders such as diabetes and dyslipidemia, ototoxic medications, smoking, and other lifestyle factors that may accelerate cochlear damage through oxidative stress and microvascular dysfunction. This narrative review aims to provide an updated overview of the genetic and environmental determinants involved in the development and progression of presbycusis. Furthermore, it discusses the clinical implications of these factors for early identification, audiological evaluation, prevention strategies, and personalized management approaches. A better understanding of the multifactorial nature of presbycusis may support the development of targeted interventions to preserve hearing function and improve overall health outcomes in the aging population. Full article

Background/Objectives: Pregnancy involves significant hormonal, cardiovascular, and physiological shifts that may potentially affect the vestibular system. The utricle and saccule, the two primary otolith organs, are responsible for detecting linear acceleration and maintaining equilibrium. This study aims to objectively evaluate the functional status of these organs throughout the three trimesters of pregnancy using Vestibular Evoked Myogenic Potentials (VEMPs). Methods: A prospective cross-sectional study was conducted with 64 healthy primigravida women (mean age 29.4 ± 2.3 years). Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) tests were performed at three distinct time points: the first (8–9 weeks), second (20–21 weeks), and third (33–34 weeks) trimesters. Latencies (p13 and n23 for cVEMP; n10 and p15 for oVEMP) and peak-to-peak amplitudes were recorded and statistically compared across trimesters. Results: No statistically significant differences were found in cVEMP p13 and n23 latencies or amplitudes across the three trimesters (p > 0.05). Similarly, oVEMP p15 latencies and amplitudes remained stable throughout the pregnancy (p = 0.43 and p = 0.95, respectively). While a slight numerical increase in certain latencies was observed in the third trimester, and the oVEMP n10 latency was found to be consistently prolonged compared to non-pregnant norms, these values remained stable between trimesters. The inter-aural asymmetry showed no significant deviations, indicating a balanced vestibular adaptation. Conclusions: The functional integrity of the saccule and utricle is preserved during a healthy pregnancy. Despite the dramatic increase in gestational hormones such as estrogen and progesterone, the otolith-dependent reflex pathways (vestibulocollic and vestibulo-ocular) remain resilient. These results provide a clinical baseline for evaluating vestibular symptoms in pregnant populations, suggesting that significant VEMP abnormalities should prompt investigation into underlying vestibular pathologies rather than being attributed to normal pregnancy changes. Full article

Background: Vestibular migraine (VM) is a common cause of episodic vertigo, yet its diagnosis remains primarily clinical and is often complicated by the absence of reliable objective biomarkers. Pupillary nystagmus, reflecting spontaneous oscillations of pupil diameter, has been proposed as a potential clinical sign of VM, but its quantitative characterization remains limited. Objective: The objective of this study is to evaluate the diagnostic value of pupillary nystagmus in VM and to provide a quantitative assessment using infrared pupillometry. Methods: In this case–control study, 137 patients with vestibular migraine and 102 healthy controls underwent comprehensive neuro-otological evaluation, including vestibular testing and pupillometric assessment. Pupillary activity was recorded using a dedicated infrared pupillometer, and oscillatory dynamics were quantified using the Pupillary Unrest Activity Level (PUAL), which was derived through spectral analysis (Larson–Neice algorithm). Statistical comparisons were performed using non-parametric methods. Results: PUAL values differed significantly between VM patients and controls (Mann–Whitney test p < 0.001), demonstrating a clear separation between groups. A cut-off value of 0.325 was identified as the upper limit of normality, suggesting that elevated PUAL values may indicate vestibular migraine. Conclusions: Pupillary nystagmus represents a clinically accessible sign that can be objectively quantified through infrared pupillometry. The PUAL index provides a measurable parameter reflecting altered vestibulo–autonomic dynamics in VM and may serve as a promising neuro-otological biomarker. The integration of pupillometric analysis with clinical evaluation may improve diagnostic accuracy and support the development of objective diagnostic tools in vestibular migraine. Full article

Objectives: This study aimed to analyse the effects of educational levels, sex, and residence on tinnitus-related distress, as well as the severity of depression and anxiety. Material and methods: A total of 235 patients with primary subjective tinnitus participated in the study. These patients underwent thorough evaluations in otorhinolaryngology and audiology. Additionally, all patients completed the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and the Generalised Anxiety Disorder-7 (GAD-7) questionnaires. Results: Patients with a primary school education scored significantly higher on the functional (F) subscale of the THI. When examining depression and anxiety levels, it was observed that patients with a primary school education exhibited the highest levels of anxiety, whereas those with a university education displayed the highest levels of depression. When analysing the effects of residency, slightly lower total THI scores were observed in individuals living in metropolitan areas. When comparing the subscale results of the THI, patients residing in metropolitan areas exhibited significantly lower scores on the F subscale. In terms of the total BDI and GAD-7 scores, there were no statistically significant differences observed. Women had slightly higher scores on the BDI and GAD-7, without statistical differences. However, women had significantly higher total THI scores. Additionally, women exhibited statistically significantly higher scores on the catastrophic (C) subscale. However, the results for the F and emotional (E) subscales did not show any statistically significant differences. There was no correlation between age and the THI, BDI, or GAD-7 scores. Conclusions: The results of this study reveal significant differences in tinnitus distress based on sex, educational levels, and residence locations, along with the presence of psychiatric symptoms, which should also be considered in tinnitus management. Full article

Background/Objectives: Hearing loss is frequently misunderstood by communication partners and healthcare providers of patients with hearing loss alike, leading to gaps in counseling, medical adherence, and empathy. Hearing loss simulation is a technique that can clarify patient experience by illustrating how hearing loss affects daily listening and speech discrimination. The current research explores the influences of a web-based hearing loss simulator on how hearing loss is understood by communication partners, audiologists, and medical providers/students. Methods: Using a convergent parallel mixed-methods design, 72 participants (communication partners, audiologists, and medical providers/residents) completed a guided trial with the hearing simulator, either one-on-one or in group settings, and subsequently completed a questionnaire regarding their experiences. The simulation trial included demonstrations of hearing loss and amplification across four listening environments: speech in quiet, in noise, at a distance, as well as listening to instrumental music. Results: Communication partners reported that they gained a better understanding of their partner’s hearing loss, with all expressing increased feelings of empathy towards their partner and individuals with hearing loss. When compared to audiologists, communication partners were significantly more surprised by the impact of hearing loss on speech understanding. Medical providers and students emphasized the value of the simulator as a counseling tool and highly recommended that other providers use the simulator with their patients. Conclusions: Simulating hearing loss can be beneficial for counseling purposes and medical training. These findings suggest that hearing loss simulation can enhance empathy and communication across clinical and educational contexts. Full article

Background: Prolonged exposure to moderate and loud noise is known to impair hearing; however, the safety of long-duration exposure to low-level sound, such as that encountered during everyday conversation, remains unclear. This study aimed to determine the effect of continuous exposure to sound at a 65 dB sound pressure level (SPL) on auditory processing. Methods: Auditory brainstem responses (ABRs) were recorded in C57BL/6 mice before and after a 1 h exposure to a continuous pure tone at 65 dB SPL. Changes in ABR thresholds, wave amplitudes, and latencies were analyzed across frequencies and time points. Correlations between amplitude and latency changes across ABR waves were also assessed. Results: Tone exposure induced a significant, frequency-specific increase in ABR thresholds, with a mean elevation of approximately 6 dB and a maximum shift of 15 dB. Significant reductions in amplitudes and prolongations of latencies were observed in Waves I–III, while Wave V amplitude remained relatively stable. A strong negative correlation between amplitude reduction and latency increase was found in Wave I, which progressively weakened from Wave II to Wave V. These functional changes persisted for up to three hours following exposure before gradually returning to baseline. Conclusions: Prolonged exposure to low-level sound at intensities typical of conversational speech can transiently impair auditory function and alter early neural processing in the auditory pathway. These findings suggest that sound levels commonly considered safe may still pose a risk when exposure is sustained, with implications for understanding hidden hearing loss and improving early diagnostic approaches. Full article