Search Results (128)

Background: Childhood hearing loss is a public health problem of critical importance associated with speech development, academic achievement, and quality of life. Parents’ awareness and knowledge about risk factors contribute to early detection and timely intervention.  Objective: This study aims to examine Jordanian mothers’ knowledge of childhood hearing loss risk factors and investigate the impact of education level and socioeconomic status (SES) on the accuracy and comprehensiveness of this knowledge with the moderating effect of health literacy. Material and Methods: The approach employed an embedded mixed-methods design with a dominant quantitative strand supported by qualitative data, utilizing quantitative surveys (n = 250), analyzed using structural equation modeling (SEM) in SmartPLS, and qualitative interviews (n = 10), analyzed thematically to expand upon the quantitative findings by exploring barriers to awareness and healthcare-seeking behaviors. Results: The accuracy and comprehensiveness of knowledge of hearing loss risk factors were also positively influenced by maternal knowledge of hearing loss risk factors. Maternal knowledge was significantly associated with both education level and socioeconomic status (SES). Furthermore, maternal knowledge and accuracy were significantly moderated by health literacy, such that mothers with higher health literacy exhibited a stronger relationship between knowledge and accuracy. Qualitative findings revealed that individuals encountered barriers to accessing reliable information and comprehending medical advice and faced financial difficulties due to limited options for healthcare services. Conclusions: These results underscore the need for maternal education programs that address specific issues, provide simplified healthcare communication, and enhance access to pediatric audiology services. Future research should explore longitudinal assessments and intervention-based strategies to enhance mothers’ awareness and detect early childhood hearing loss. Full article

Platinum-induced ototoxicity constitutes a significant adverse effect in pediatric oncology, frequently resulting in permanent hearing impairment with profound implications for quality of life, language acquisition, and scholastic performance. This comprehensive review critically evaluates contemporary ototoxicity monitoring practices across various pediatric oncology settings, analyzes current guideline recommendations, and formulates strategies for implementing standardized surveillance protocols. Through examination of recent literature—encompassing retrospective cohort investigations, international consensus recommendations, and functional outcome assessments—we present an integrated analysis of challenges and opportunities in managing chemotherapy-associated hearing loss among childhood cancer survivors. Our findings demonstrate marked heterogeneity in monitoring methodologies, substantial implementation obstacles, and considerable impact on survivors’ functional status across multiple domains. Particularly concerning is the persistent absence of an evidence-based consensus regarding the appropriate duration of audiological surveillance for this vulnerable population. We propose a structured framework for comprehensive ototoxicity management emphasizing prompt detection, standardized assessment techniques, and integrated long-term follow-up care to minimize the developmental consequences of platinum-induced hearing impairment. This approach addresses critical gaps in current practice while acknowledging resource limitations across diverse healthcare environments. Full article

Background/Objectives: Tonal thresholds, typically assessed through pure-tone audiometry (PTA), are central to the audiological evaluation of Ménière’s disease (MD). However, they fail to capture the complexity of real-life speech perception. This study aimed to characterize the relationship between PTA and speech recognition performance in unilateral MD and to determine whether a measurable dissociation exists between hearing sensitivity and verbal processing. We also evaluated frequency-specific audiometric patterns and potential threshold cut-off values associated with speech recognition decline. Methods: A total of 254 ears from 127 patients were included in the study across three groups: the Ménière group (affected and unaffected ears, n = 64 each) and the control group (n = 63). The pure-tone thresholds, speech recognition threshold (SRT), and the maximum word recognition scores (Rmax) were assessed in all participants. Results: Although the Ménière affected and control groups showed comparable pure-tone average (PTA) values (46.33 vs. 38.13 dB, p = 0.439), the affected group demonstrated significantly poorer speech performance (Rmax: 76.25% vs. 87.49%, p < 0.001; SRT: 50.64 vs. 38.45 dB, p = 0.009). The Ménière unaffected group exhibited near-ceiling performance (Rmax: 99.38%, SRT: 18.33 dB) and a mean PTA of 19.59 dB. A strong correlation between PTA and SRT was observed only in the Ménière affected group (r = 0.942, p < 0.001), whereas correlations were moderate in the unaffected (r = 0.671, p < 0.001) and control (r = 0.728, p < 0.001) groups. The ROC analysis revealed that PTA predicted impaired speech recognition with high accuracy in unaffected (AUC = 0.956, p < 0.001) and control (AUC = 0.829, p < 0.001) ears but far less so in affected ears (AUC = 0.784; all p < 0.001), confirming a functional tonal–verbal dissociation in MD. Conclusions: This study demonstrates a functional audiometric dissociation in unilateral Ménière’s disease. Affected ears show poorer speech recognition and require higher intensities despite similar PTA values. The predictive link between thresholds and verbal performance is disrupted. These findings support the need for combined tonal and speech-based assessment in clinical practice. Full article

Objective: The aim of this study was to assess the effects of vestibular stimulation (semicircular canals/utricles) compared to cochlear stimulation on phantom pain and depersonalization/derealization symptoms after ≥3 months since traumatic amputation of hand-finger(s). Methods: A total of 125 adults (38.2 ± 8.1 years old) with phantom pain after amputation of one to four fingers agreed to participate. None of them wore prosthetic devices or had history of otology/audiology/vestibular/neurology/rheumatology/orthopedic/psychiatry disorders or psychopharmacological treatment. After a preliminary assessment, in a random order, they were exposed to caloric stimulation (right/left 44 °C/30 °C), centrifuge (right/left), and transient evoked otoacoustic emissions (TOAEs, right/left) with a follow-up of three days in between. Immediately before and after each stimulus, they reported on their pain characteristics and depersonalization/derealization symptoms. Results: After vestibular stimulation, a decrease in pain intensity was reported by at least one-third of the participants, which persisted for at least one day in the majority of them. Less than one-sixth of the participants reported pain decrease after cochlear stimulation. No influence was observed based on the side of the stimulation or the temperature, but the stimuli sequence had an effect. The centrifuge and TOAE effects were related to anxiety/depression symptoms and mainly observed when they were the first stimulus used. After caloric stimulation, pain decrease was independent from the sequence of the stimuli, and it was related to reports of feeling estrangement from the body. Conclusions: Mild caloric vestibular stimulation, whether applied to the right or left side and using warm or cold temperature, can modulate phantom pain after amputation of hand-finger(s) in patients with altered bodily sensations. However, individual cofactors may influence one’s susceptibility to experiencing this effect. Full article

Background and Objectives: Systemic small-vessel vasculitis (SV) represents a group of rare autoimmune disorders with varied etiologies and clinical manifestations. Audiovestibular involvement in SV may present with a broad spectrum of symptoms, often complicating diagnosis and management. This study aimed to evaluate auditory function and speech perception in individuals diagnosed with SV and to investigate associations with disease-specific clinical parameters. Materials and Methods: A total of 40 patients diagnosed with SV (mean age: 48.9 years; range: 28–65 years) were recruited for comprehensive audiological assessment. The evaluation protocol included otoscopic examination, tympanometry, pure-tone audiometry, and speech audiometry. Statistical analysis was conducted using R software (version 4.3.1), and significance was set at p < 0.05. Results: Diagnoses included granulomatosis with polyangiitis (52.5%), eosinophilic granulomatosis with polyangiitis (27.5%), necrotizing vasculopathy (12.5%), and microscopic polyangiitis (7.5%). Mean disease duration was 4.14 years. Hearing complaints were reported by 77.5%; in 20%, they were the initial symptoms. Audiometry identified hearing loss in 50% of patients—predominantly sensorineural (33.8%), followed by mixed (13.7%) and conductive (2.5%) types. Hearing loss was most frequent in necrotizing vasculopathy (60%) and among ANCA-positive individuals (53.7%). Conclusions: Sensorineural hearing loss is common in SV, particularly in ANCA-positive patients, highlighting the need for routine hearing assessment in SV management. Full article

Background: Tele-practice, as an evidence-based practice, has gained momentum over the last two decades. However, routine clinical adoption is not spontaneous. Implementation science facilitates stakeholder engagement and the assessment of needs and plans. The study aims to assess the needs related to audiology and speech–language pathology services for children under six years of age and readiness for a tele-practice-based model of care for diagnostic and rehabilitation services among parents within the public sector in Tamil Nadu. Methods: A cross-sectional study design was used. The qualitative methods of focus group discussions and semi-structured interviews were conducted for parents of children with disabilities. A quantitative community survey was conducted on parents of children with no known disabilities. A deductive-inductive method of analysis was used. Results: Community survey responses were analyzed using percentage analysis. The results were classified based on the constructs of Bowen’s feasibility framework: demand/need for tele-practice, acceptability of tele-practice, and integration and practicality of tele-practice. Parents considered the existing services to be inadequate. Parents perceived tele-practice as beneficial, yet they felt a hybrid method would be more suitable, with sufficiently interspersed in-person visits. Parents believed that training and community awareness were necessary before implementing a technology-based model of services. Conclusions: The study’s findings guided the fine-tuning of the proposed comprehensive tele-practice model for hearing and speech–language services for children in this rural district. Full article

Background/Objectives: Hearing aids are essential for managing hearing loss, yet their accessibility, consistent use, and maintenance remain challenging in public healthcare systems, particularly in low- and middle-income countries (LMICs) such as South Africa. Despite the availability of these services, many patients struggle with device utilization, resulting in suboptimal rehabilitation outcomes. This study explores patient experiences with hearing aids in South Africa’s public healthcare sector. This study aimed to (1) assess patients’ experiences with hearing aid access, including waiting times and service delivery; (2) identify challenges related to hearing aid maintenance and repairs in the public sector; (3) explore factors influencing consistent hearing aid use, including social, psychological, and practical barriers; and (4) propose strategies to enhance hearing aid provision and aftercare services in South Africa. Methods: This descriptive qualitative study was conducted at two public healthcare facilities in Johannesburg. Purposive sampling was used to recruit 15 adult hearing aid users who had received government-funded hearing aids within the past 12 months. Semi-structured interviews were conducted, transcribed verbatim, and analyzed using thematic analysis. Results: Participants reported long waiting periods (up to a year) for hearing aids, with poor communication regarding timelines. Challenges included difficulties adjusting to amplification, discomfort, and battery shortages, leading to inconsistent use or device abandonment. Social stigma and lack of family support further discouraged consistent use. Repair services were slow, with waiting times exceeding three months. Participants recommended decentralized battery distribution, structured follow-up appointments, improved aftercare, awareness campaigns, and mobile audiology services to improve accessibility and usability. Conclusions: While public hearing aid provision is essential for hearing rehabilitation, systemic inefficiencies, maintenance issues, and social barriers limit its impact. Strengthening aftercare services, decentralizing hearing aid distribution, and increasing public awareness could significantly improve hearing aid accessibility and adherence. Furthermore, policy interventions that incorporate tele-audiology, community-based maintenance programs, and integrated healthcare approaches are crucial in ensuring sustainable hearing healthcare outcomes. Full article

Hearing plays a significant role in children’s development. The Auditory Steady State Response (ASSR) using a narrow band CE^® chirp is a technique that allows multiple stimuli to be presented simultaneously, making it possible to obtain electrophysiological thresholds with frequency specificity. The objective of this work is to analyze the findings obtained with the ASSR NB-CE^® chirp technique and compare them with two other methodologies—click ABR and tone-burst ABR—in the audiological assessment of children carried out under inhalation anesthesia. All the exams were performed in a single session. This study involved 71 children aged between 14 and 59 months, male and female, who were referred for ABR and ASSR due to suspected hearing loss and/or delay in speech/language development. Pearson’s correlation coefficient between the uncorrected and corrected thresholds obtained in the three methods demonstrated high correlations for all frequencies evaluated. Full article

Background/Objectives: Cochlear implantation is a crucial intervention for individuals with severe hearing loss, aiming to restore auditory function and improve quality of life. The decision to recommend cochlear implantation critically depends on accurate audiological evaluations. However, challenges arise when subjective assessments of hearing loss do not align with objective audiological measurements, leading to potential misdiagnoses. Comparisons are to be made between subjective and objective results, with an investigation into the characteristics, warning signs, and risk factors of functional hearing loss (FHL). Methods: A retrospective study of hearing loss presentations at an otorhinolaryngological university clinic between 2020 and 2024 was performed, whereby we collected FHL cases. The evaluation process included measurements of subjectively perceived hearing loss through pure-tone audiometry, speech understanding, and communication testing. The objective assessments comprised impedance measurement, otoacoustic emission measurement, auditory brainstem responses, auditory steady-state responses, and medical imaging. Results: During the studied period, 11 patients, with an average age of 35.2 years (13 to 64 years), who were originally referred for cochlear implantation evaluation and subsequently diagnosed with FHL, were identified. The majority (10 patients) were female. No organic cause was identified in four cases, while seven cases exhibited some organic ear abnormalities insufficient to justify the reported hearing loss. The degree of FHL ranged from 30 dB to 90 dB, with an average of 60 dB. Conclusions: Diagnosing FHL is challenging and requires comprehensive assessment and interdisciplinary collaboration. Failure to recognize it may lead to inappropriate treatment, including unnecessary cochlear implantation. This study advocates for the mandatory integration of ABR and ASSR in the clinical evaluation of all cochlear implant candidates to ensure accurate diagnosis and optimal treatment. Full article

Background: Occupational hearing loss (OHL) is a primary concern in industrial settings. In hospitals, the healthcare workers are also exposed to noise and chemical agents, the reported hearing loss in this occupation is underestimated. Hearing examination is routinely evaluated in the range of conventional frequencies, which may not detect hearing problems early. Therefore, this study aimed to reveal the hearing thresholds among medical personnel exposed to loud noise and/or chemical environments, estimating the prevalence of hearing loss using four different audiological methods. Methods: One hundred and thirty-one medical personnel were recruited from different units at the same hospital and grouped into noise, chemical, and mixed exposure categories. The hearing thresholds were assessed using four audiological methods, conventional audiometry (CA), extended high-frequency audiometry (EHFA), standard frequency distortion product otoacoustic emission (DPOAE), and ultra-high-frequency DPOAE. Statistical analyses were performed using R. Results: Ultra-high-frequency DPOAE and EHFA showed a higher prevalence of hearing loss than CA and DPOAE. Even CA usually demonstrated hearing threshold within normal limits, this study found a notch audiogram pattern indicating a decline in hearing loss over time at frequencies of 2, 3, and 4 kHz in each age group and a sign at a frequency of 6 kHz. Conclusions: Evidence of hearing loss can be identified with ultra-high-frequency DPOAE and EHFA, despite conventional audiometry indicating normal hearing thresholds. Full article

Pesticide exposure poses a significant health risk, with emerging evidence suggesting its impact on auditory function. This study investigated the effects of pesticide exposure on hearing in young rural residents living near agricultural areas in Chile’s O’Higgins Region. We evaluated 51 participants (31 exposed, 20 unexposed) aged 18–35 years, using comprehensive audiological assessments including high-frequency audiometry, distortion product otoacoustic emissions (DPOAEs), and auditory brainstem responses (ABR). Participants were classified based on residential proximity to agricultural areas, with exposed individuals living around 400 m or less from monoculture fields. Results revealed significant differences in high-frequency hearing thresholds (14 and 16 kHz) in exposed individuals. The exposed group showed a higher number of absent DPOAEs and reduced ABR wave V amplitude in the right ear compared to the unexposed group. Additionally, the wave V/I ratio was significantly lower in exposed individuals. These findings suggest that pesticide exposure, even without direct occupational contact, may induce measurable changes in auditory function, particularly affecting high-frequency hearing and neural responses. These results emphasize the need for enhanced monitoring and protective measures for populations residing near agricultural areas where pesticides are extensively used. Full article

Cytomegalovirus (CMV) infection in pregnant women is one of the most common causes of congenital infection in children. It is often asymptomatic but can lead to serious complications, including progressive sensorineural hearing loss. Profound hearing loss is an indication for cochlear implantation (CI). Electrode impedance and neural response telemetry (NRT) thresholds can be measured to confirm correct electrode placement and speech processor programming. Background/Objectives: The aim of the study is to evaluate the hearing outcome of children with profound sensorineural hearing loss or deafness due to cCMV infection after CI compared to a control group of children born with other causes of congenital hearing loss and to identify prognostic factors predicting the outcome of patients with hearing loss due to cCMV infection after CI. Methods: A retrospective study was conducted in patients implanted between 2016 and 2023 at the Department of Otolaryngology of the Institute of the Polish Mother’s Memorial Hospital Research Institute in Łódź. Pre- and postoperative hearing levels, electrode impedance and neural response telemetry (NRT) thresholds were compared. The degree of pre-implantation hearing loss was assessed by the level of the recorded V-wave in the ABR test. Post-implantation hearing assessment was based on the last available free-field tonal audiometry measurement. Impedance measurements were included: intraoperative, 1, 6, 12 months after CI, respectively, and NRT thresholds. Results: The final analysis included 84 patients with profound sensorineural hearing loss and complete audiological follow-up data: 13 patients with congenital CMV (cCMV) infection and 71 patients with other causes of deafnes. The analysis included 175 implanted ears: 17 in the CMV group and 158 in the control group. The age at implantation ranged from 1 to 11 years in the CMV and from 1 to 13 years in the control group. Mean preoperative hearing thresholds were 94.54 dB in the CMV group and 97.04 dB in the control group. At the most recent postoperative evaluation, mean thresholds improved to 33.83 dB and 36.42 dB, respectively. No statistically significant differences were observed between the groups. Mean intraoperative NRT values were 79.74 in the CMV group and 86.90 in the non-CMV group. Final NRT values were 129.77 and 130.76, respectively. Mean impedance values measured intraoperatively and at 1, 6 and 12 months postoperatively were 11.09 kOhm, 13.40 kOhm, 8.35 kOhm and 8.25 kOhm in the CMV group; and 12.28 kOhm, 14.06 kOhm, 9.60 kOhm and 8.00 kOhm in the control group, respectively. Conclusions: CI in children with deafness caused by cCMV infection is an effective treatment option. Initial electrical impedance values of the electrodes increase after implant activation and decrease in subsequent months of follow-up, suggesting the absence of active adhesion processes in the cochlea. Full article

Background/Objectives: Unilateral hearing loss (UHL) is a relatively common disability condition comprising around 20–50% of all congenital hearing loss (HL). The adverse effects of UHL affect the typical development of auditory function with implications for communication, speech and language acquisition, academic development and quality of life. Current literature suggests an early intervention treatment in order to avoid developmental delays, but there is a lack of evidence about the effectiveness and use of hearing devices. The purpose of the present study was to evaluate the benefits of rehabilitative strategies such as hearing aid (HA) and cochlear implant (CI) in UHL children by exploring audiological and parent-reported outcomes. Methods: A total of 18 UHL children, between the ages of 3 and 17, were enrolled in the study designed as a prospective longitudinal study from July 2023 to July 2024. All children were evaluated for speech perception in quiet and noise and subjective benefits before and after rehabilitative treatment with HA in 15 (83.3%) children and with CI in 3 (16.7%) children. Results: The evaluation of audiological outcomes in children with UHL, based on assessment of aided sound field thresholds and speech perception scores assessment versus unaided, shows improvements in audiometric thresholds and how the hearing devices adequately support listening and spoken language. Scores with hearing devices were significantly higher than baseline-only scores when averaging both SSQ and CHILD questionnaires, pointing to an overall rehabilitative benefit. Conclusions: Rehabilitative interventions, particularly HA and CI, offer notable benefits when introduced early, but achieving optimal outcomes requires a multidisciplinary and individualized approach. Full article

Hearing loss remains a significant but underexplored health challenge in individuals with HIV/AIDS, particularly those exposed to occupational noise. The ototoxic effects of antiretroviral therapy (ART) and comorbid conditions like tuberculosis (TB) further compound the risk. This narrative review examines the intersection of HIV/AIDS, ART, and occupational noise-induced hearing loss (ONIHL), emphasizing the South African and broader African contexts. The aim of the study was to map the existing literature on the association between HIV/AIDS, its treatments, and ONIHL, and to identify research gaps to inform policy and clinical practice. A narrative review approach was adopted, systematically searching databases including PubMed, Scopus, and Web of Science. Studies published between 2000 and 2024 were included, focusing on the effects of HIV/AIDS, ART, and occupational noise exposure on hearing health. Data extraction and thematic synthesis were performed to identify key findings and gaps. Twenty studies were included, covering diverse settings such as South Africa, Cameroon, Tanzania, and the USA. Three key themes emerged: (1) dual burden of HIV and occupational noise exposure: HIV-positive individuals in noise-intensive industries, such as mining, face amplified risks of hearing loss due to immunological compromise and ototoxic TB treatments; (2) ototoxicity of ART: older ART regimens, widely used in resource-limited settings, are associated with a higher prevalence of sensorineural hearing loss (SNHL); and (3) immunological susceptibility to ONIHL: HIV-related immune suppression exacerbates cochlear damage from noise and ototoxic agents, contributing to both peripheral and central auditory dysfunction. This review highlights the urgent need for integrated hearing health interventions in HIV care and occupational health frameworks, particularly in high-prevalence regions like South Africa. Routine audiological assessments, access to safer ART regimens, and enhanced workplace protections are essential to mitigate the dual burden of HIV/AIDS and ONIHL. Future research should prioritize longitudinal studies and innovative, low-cost solutions for resource-limited settings. Full article

Objectives: This study aimed to translate, cross-culturally adapt, and evaluate the psychometric properties of the Persian version of the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA) in elderly Iranian adults. Methods and Materials: This cross-sectional study was conducted in Tehran, 2021. Following translation and cross-cultural adaptation, the face validity, content validity, and reliability of the questionnaire were assessed. The Satisfaction with Amplification in Daily Life (SADL) questionnaire was used to assess concurrent validity. Study participants included 300 hearing-aid users aged 60 years and older who completed the research instruments. Data were analyzed using Confirmatory Factor Analysis (CFA), Cronbach’s alpha coefficient, Pearson correlation coefficient, independent t-tests, and analysis of variance (ANOVA) in SPSS and AMOS version 24. The significance level was set at p ≤ 0.05 for all tests. Results: The mean (SD) age of the participants was 71.38 (8.05) years. The face and content validity of the questionnaire were confirmed by ten experts (CVI > 0.91). The CFA supported the four-factor structure of the questionnaire, and the goodness-of-fit indices indicated that the final model had a good fit. The Cronbach’s alpha for the total questionnaire was 0.93, and for the subscales, it ranged between 0.83 and 0.93. The Pearson’s correlation analysis results showed a positive and significant correlation between MARS-HA and SADL scores (r = 0.61, p < 0.05), supporting criterion validity. Conclusions: The P-MARS-HA questionnaire demonstrates good validity and reliability and can be used as an appropriate tool for assessing self-efficacy in hearing-aid use among elderly Iranian adults. Full article