Search Results (3,804)

Background: Fixed-dose combinations have advanced in many therapeutic areas, including otorhinolaryngology, where hearing disorders are increasingly prevalent. Objectives: The present study focuses on developing and evaluating a new capsule combining nicergoline (NIC), piracetam (PIR), and hawthorn extract (HE) for the management of sensorineural hearing loss. Methods: The first phase methodology comprised preformulation studies (DSC, FTIR, and PXRD) to assess compatibility among active substances and excipients. Subsequently, four formulations were prepared and tested for flowability, dissolution behavior in acidic and neutral media, and stability under oxidative, thermal, and photolytic stress. Quantification of the active substances and flavonoids was performed using validated spectrophotometric and HPLC-UV methods. Results: Among the tested variants, the F1 formulation (4.5 mg NIC, 200 mg PIR, 50 mg HE, 2.5 mg magnesium stearate, 2.5 mg sodium starch glycolate, and 240.5 mg monohydrate lactose per capsule) displayed optimal technological properties, superior dissolution in acidic media, and was further selected for evaluation. The antioxidant activity of the formulation was confirmed through the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, Trolox Equivalent Antioxidant Capacity (TEAC), and iron chelation tests, and was primarily attributed to the flavonoid content of the HE. Acute toxicity tests in mice and rats indicated a high safety margin (LD₅₀ > 2500 mg/kg), while ototoxicity assessments showed no adverse effects on auditory function. Conclusions: The developed formulation displayed good stability, safety, and therapeutic potential, while the applied workflow could represent a model for the development of future fixed-dose combinations. Full article

Background: Cochlear implantation (CI) in pediatric patients with cochlear nerve deficiencies (CND) remains controversial due to a highly variable clinical population, lack of evidence-based guidelines, and mixed research findings. This study assessed current clinical perspectives and practices regarding CI candidacy in children with CND among hearing healthcare professionals in the USA. Methods: An anonymous 19-question online survey was distributed to CI clinicians nationwide. The survey assessed professional background, experience with aplasia and hypoplasia, and perspectives on CI versus auditory brainstem implant (ABI) candidacy, including imaging practices and outcome expectations. Both multiple-choice and open-ended responses were analyzed to identify trends and reasoning. Results: Seventy-two responses were analyzed. Most clinicians supported CI for hypoplasia (60.2%) and, to a lesser extent, for aplasia (41.7%), with audiologists more likely than neurotologists to favor CI. Respondents cited lower risk, accessibility, and the potential for benefit as reasons to attempt CI before ABI. However, many emphasized a case-by-case approach, incorporating imaging, electrophysiological testing, and family counseling. Only 22.2% considered structural factors the best predictors of CI success. Conclusions: Overall, hearing health professionals in the USA tend to favor CI as a first-line option, while acknowledging the limitations of current diagnostic tools and the importance of individualized, multidisciplinary decision-making in CI candidacy for children with CND. Findings reveal a high variability in clinical perspectives on CI implantation for pediatric aplasia and hypoplasia and a lack of clinical consensus, highlighting the need for more standardized assessment and imaging protocols to provide greater consistency across centers and enable the development of evidence-based guidelines. Full article

Filled pauses are thought to be reflections of linguistic processes (e.g., lexical retrieval, speech planning and execution). Uh may be a self-directed cue for when a speaker needs more time to retrieve lexical–semantic representations, whereas um serves as a listener-directed, pragmatic cue. The use of filled pauses has not been examined in children who are hard of hearing (CHH). Participants included 68 CHH and 33 children with typical hearing (CTH). Participants engaged in conversations, expository discourse, and fable retells. We analyzed filled pauses as a function of hearing status and discourse contexts and evaluated the relationship between filled pauses and language ability. CHH produced uh across discourse contexts more often than their hearing peers. CHH did not differ in their use of um relative to CTH. Both um and uh were used more often in conversational samples compared to other types of discourse. Spearman’s correlations did not show any significant associations between the rate of filled pauses and standardized language scores. These results indicate that CHH produces uh more often than CTH, suggesting that they may have difficulty retrieving lexical–semantic items during ongoing speech. This information may be useful for interventionists who are collecting language samples during assessment. Full article

Background/Objectives: This study aimed to investigate the optimal sound presentation level for sound localization testing to assess the effect of hearing interventions in individuals with unilateral conductive hearing loss (UCHL). Methods: Nine participants with normal hearing were tested, and simulated two-stage UCHL was created using earmuffs and earplugs. We created two types of masking conditions: (1) only an earplug inserted, and (2) an earplug inserted with an earmuff worn. A sound localization test was performed for each condition. The sound presentation levels were 40, 45, 50, 55, 60, 65, and 70 dB SPL, and the results were evaluated using root mean square and d-values. Results: Both values showed little difference in masking Condition 2, regardless of the sound presentation level, whereas in masking Condition 1, the values were at their minimum at 55 dB SPL. In addition, comparing the differences between masking Conditions 1 and 2 for each sound presentation level, the greatest difference was observed at 55 dB SPL for both values. Conclusions: The optimal sound presentation level for sound localization testing to assess hearing intervention effects in UCHL was 55 dB. This result may be attributed to the effect of input from the non-masked ear, accounting for interaural attenuation; the effect was considered minimal at 55 dB SPL. Full article

Background/Objectives: This study investigated the association between cochlear implant (CI) users’ assessed perception of musical sound quality and their subjective music perception and music-related quality of life (QoL). The aim was to provide a comprehensive evaluation by integrating a relatively objective Turkish Multiple Stimulus with Hidden Reference and Anchor (TR-MUSHRA) test and a subjective music questionnaire. Methods: Thirty CI users and thirty normal-hearing (NH) adults were assessed. Perception of sound quality was measured using the TR-MUSHRA test. Subjective assessments were conducted with the Music-Related Quality of Life Questionnaire (MuRQoL). Results: TR-MUSHRA results showed that while NH participants rated all filtered stimuli as perceptually different from the original, CI users provided similar ratings for stimuli with adjacent high-pass filter settings, indicating less differentiation in perceived sound quality. On the MuRQoL, groups differed on the Frequency subscale but not the Importance subscale. Critically, no significant correlation was found between the TR-MUSHRA scores and the MuRQoL subscale scores in either group. Conclusions: The findings demonstrate that TR-MUSHRA is an effective tool for assessing perceived sound quality relatively objectively, but there is no relationship between perceiving sound quality differences and measures of self-reported musical engagement and its importance. Subjective music experience may represent different domains beyond the perception of sound quality. Therefore, successful auditory rehabilitation requires personalized strategies that consider the multifaceted nature of music perception beyond simple perceptual judgments. Full article

Background: Understanding the origin and natural organization of early infant vocalizations is important for predicting communication and language abilities in later years. The very frequent production of speech-like vocalizations (hereafter “protophones”), occurring largely independently of interaction, is part of this developmental process. Objectives: This study aims to investigate the gap durations (time intervals) between protophones, comparing typically developing (TD) infants and infants later diagnosed with autism spectrum disorder (ASD) in a naturalistic setting where endogenous protophones occur frequently. Additionally, we explore potential age-related variations and sex differences in gap durations. Methods: We analyzed ~1500 five min recording segments from longitudinal all-day home recordings of 147 infants (103 TD infants and 44 autistic infants) during their first year of life. The data included over 90,000 infant protophones. Human coding was employed to ensure maximally accurate timing data. This method included the human judgment of gap durations specified based on time-domain and spectrographic displays. Results and Conclusions: Short gap durations occurred between protophones produced by infants, with a mode between 301 and 400 ms, roughly the length of an infant syllable, across all diagnoses, sex, and age groups. However, we found significant differences in the gap duration distributions between ASD and TD groups when infant-directed speech (IDS) was relatively frequent, as well as across age groups and sexes. The Generalized Linear Modeling (GLM) results confirmed these findings and revealed longer gap durations associated with higher IDS, female sex, older age, and TD diagnosis. Age-related differences and sex differences were highly significant for both diagnosis groups. Full article

Harbor seals (Phoca vitulina) have excellent perception of water disturbances and can still sense targets as far as 180 m away, even when they lose their vision and hearing. This exceptional capability is attributed to the undulating structure of its vibrissae. These specialized whiskers not only effectively suppress vortex-induced vibrations (VIVs) during locomotion but also amplify the vortex street signals generated by the wake of a target, thereby enhancing the signal-to-noise ratio (SNR). In recent years, researchers in fluid mechanics, bionics, and sensory biology have focused on analyzing the hydrodynamic characteristics of seal vibrissae. Based on bionic principles, various underwater biomimetic seal whisker sensors have been developed that mimic this unique geometry. This review comprehensively discusses research on the hydrodynamic properties of seal whiskers, the construction of three-dimensional geometric models, the theoretical foundations of fluid–structure interactions, the advantages and engineering applications of seal whisker structures in suppressing VIVs, and the design of sensors inspired by bionic principles. Full article

Some children with autism may require additional support to meet academic expectations for comprehension. Because an extensive set of research links oral narration to listening and reading comprehension, the promotion of narrative-based skills may be a viable intervention approach. The purpose of this study was to examine the effect of narrative intervention with explicit strategy instruction on the listening and reading retells of children with autism after hearing and decoding novel stories. Four children with autism aged 7 and 9 years old participated in this multiple baseline across participants single-case experimental design study. Behavioral therapists delivered the narrative intervention, which included explicit instruction on the use of story grammar icons, to each child individually within the course of their therapy. Results showed that all participants improved their listening (TauU ES range = 0.64–1.06) and reading (TauU ES range = 0.72–1.15) retells, but they required extended use of the icon strategy to achieve the most benefit. When icons were completely removed, three of the four participants performed above baseline levels on the listening and reading comprehension measures. Full article

Background/Objectives: Traditional hearing aid noise reduction algorithms offer no additional benefit in noisy situations for bimodal cochlear implant (CI) users with a CI in one ear and a hearing aid (HA) in the other. Recent breakthroughs in deep neural network (DNN)-based noise reduction have improved speech understanding for hearing aid users in noisy environments. These advancements could also boost speech perception in noise for bimodal CI users. This study investigated the effectiveness of DNN-based noise reduction in the HAs used by bimodal CI patients. Methods: Eleven bimodal CI patients, aged 71–89 years old, were fit with a Phonak Audéo Sphere Infinio 90 HA in their non-implanted ear and were provided with a Calm Situation program and Spheric Speech in Loud Noise program that uses DNN-based noise reduction. Sentence recognition scores were measured using AzBio sentences in quiet and in noise with the CI alone, hearing aid alone, and bimodally with both the Calm Situation and DNN HA programs. Results: The DNN program in the hearing aid significantly improved bimodal performance in noise, with sentence recognition scores reaching 79% compared to 60% with Calm Situation (a 19% average benefit, p < 0.001). When compared to the CI-alone condition in multi-talker babble, the DNN HA program offered a 40% bimodal benefit, significantly higher than the 21% score seen with the Calm Situation program. Conclusions: DNN-based noise reduction in HA significantly improves speech understanding in noise for bimodal CI users. Utilization of this technology is a promising option to address patients’ common complaint of speech understanding in noise. Full article

Objective: To evaluate the outcomes of a modified infratemporal fossa approach (ITFA) that preserves the posterior external auditory canal (EAC) in patients with tumors in the infratemporal fossa and skull base, focusing on postoperative hearing and facial nerve function. Methods: This retrospective study included nine patients who underwent ITFA with posterior EAC preservation for tumor removal while minimizing facial nerve rerouting. All surgeries were performed by a single surgeon. Preoperative and postoperative hearing levels, facial nerve function, tumor characteristics, and surgical outcomes were analyzed. Air-bone gaps (ABG) were assessed using pure tone audiometry, and facial nerve function was assessed using the House–Brackmann grading system. Results: The cohort consisted of eight female patients and one male patient, with a mean tumor size of 3.0 cm. Surgical outcomes were promising, with no statistically significant increase in postoperative ABG and well-preserved facial nerve function. Only one patient developed postoperative grade II facial palsy. A residual tumor was identified in one case with extensive meningioma, which has remained stable, and no recurrence or regrowth was noted during the follow-up period (mean: 3.7 years). The modified approach minimized complications related to conductive hearing loss and facial nerve dysfunction. Conclusions: The modified ITFA with posterior EAC preservation provides a promising alternative to conventional ITFA for managing deep-seated tumors. It preserves both hearing and facial nerve function while ensuring adequate tumor resection. Full article

Diffusion tensor imaging (DTI) metrics provide insights into neural pathways, which can be pivotal in differentiating congenital and acquired hearing loss to support diagnosis, especially for those diagnosed late. In this study, we analyzed DTI parameters and developed machine learning to classify these two patient groups. The study included 29 patients with congenital hearing loss and 6 with acquired hearing loss. DTI scans were performed to obtain metrics, such as fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Statistical analyses based on p-values highlighted the cortical auditory system’s prominence in differentiating between groups, with FA and RD emerging as pivotal metrics. Three machine learning models were trained to classify hearing loss types for each of five dataset scenarios. Random forest (RF) trained on a dataset consisting of significant features demonstrated superior performance, achieving a specificity of 87.12% and F1 score of 96.88%. This finding highlights the critical role of DTI metrics in the classification of hearing loss. The experimental results also emphasized the critical role of FA in distinguishing between the two types of hearing loss, underscoring its potential clinical utility. DTI parameters, combined with machine learning, can effectively distinguish between congenital and acquired hearing loss, offering a robust tool for clinical diagnosis and treatment planning. Further research with larger and balanced cohorts is warranted to validate these findings. Full article

Background/Objectives: Speech intelligibility (SI) is a key indicator of spoken language development, especially for children with hearing loss, as it directly impacts communication and social engagement. However, due to logistical and methodological challenges, SI assessment is often underutilised in clinical practice. This study aimed to evaluate the accuracy and consistency of an artificial intelligence (AI)-based transcription model in assessing SI in young children with cochlear implants (CI), hearing aids (HA), or normal hearing (NH), in comparison to naïve human listeners. Methods: A total of 580 speech samples from 58 five-year-old children were transcribed by three naïve listeners and the AI model. Word-level transcription accuracy was evaluated using Bland–Altman plots, intraclass correlation coefficients (ICCs), and word error rate (WER) metrics. Performance was compared across the CI, HA, and NH groups. Results: The AI model demonstrated high consistency with naïve listeners across all groups. Bland–Altman analyses revealed minimal bias, with fewer than 6% of sentences falling outside the 95% limits of agreement. ICC values exceeded 0.9 in all groups, with particularly strong agreement in the NH and CI groups (ICCs > 0.95). WER results further confirmed this alignment and indicated that children with CIs showed better SI performance than those using HAs. Conclusions: The AI-based method offers a reliable and objective solution for SI assessment in young children. Its agreement with human performance supports its integration into clinical and home environments for early intervention and ongoing monitoring of speech development in children with hearing loss. Full article

Background/Objectives: Despite its significant impact on learning, classroom acoustics and students’ hearing difficulties are often overlooked compared with more visible issues like lighting. Hearing loss—frequently underestimated and invisible—affects both students and teachers, potentially leading to fatigue, reduced participation, and academic challenges. The A.BA.CO. project in Italy was developed to address these issues by promoting improved classroom design, technological solutions, and better auditory communication accessibility in schools. Objective: This article presents the A.BA.CO. project, offering context and an overview of the preliminary analyses conducted by its multidisciplinary team. The goal is to share insights and propose organizational frameworks, technical solutions, and best practices concerning the hearing, communication, and auditory learning challenges experienced by students with hearing impairments. Results: The A.BA.CO. team’s analyses identified key barriers to inclusion for students with (or without) hearing impairments, such as poor classroom acoustics, excessive noise, and suboptimal seating arrangements. The project underscores the importance of improved acoustic environments and the integration of assistive technologies, including speech-to-text systems. The findings highlight the need for interdisciplinary collaboration to design accessible and inclusive educational settings for all learners. Conclusions: Embedding educational audiology within school systems—alongside enhancements in classroom acoustics and the use of assistive technologies and other technological solutions—is essential to ensure that all students, regardless of hearing ability, have equitable access to learning and full participation in educational life. Full article