Search Results (459)

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: Age-related hearing loss (HL) is a significant independent risk factor for Alzheimer’s disease (AD), yet the molecular mechanisms underlying this comorbidity and the comparative efficacy of hearing interventions for cognitive outcomes remain unclear. This study aims to integrate clinical evidence and molecular data to address these gaps. Objective: The objective of this study was to conduct a systematic review and network meta-analysis (NMA) in order to: (1) compare the effects of hearing interventions on cognitive function in AD patients; (2) identify and rank key microRNAs (miRNAs) associated with AD-HL comorbidity; (3) explore heterogeneity sources; and (4) cross-validate findings with internal clinical sequencing data. Methods: We systematically searched PubMed, Web of Science, Embase, and the Cochrane Library, with a cut-off date of May 2024. Included studies involved AD patients with/without HL, reporting cognitive scores (MoCA, MMSE, and AVLT) or miRNA expression data. An NMA was performed to rank interventions (cochlear implants—CIs, hearing aids—HAs, and no intervention—NI) and miRNAs using surface under the cumulative ranking (SUCRA) curves. Heterogeneity was assessed via subgroup analysis and meta-regression. Pooled miRNA expression results were cross-validated against an internal clinical sequencing dataset (LC-P20240110033, n = 16) using the intraclass correlation coefficient (ICC) and Bland–Altman plots. Results: Twelve studies (2137 patients) were included. HL was significantly associated with worse cognitive function (MoCA: SMD = −0.82, 95% CI: −1.15 to −0.49; AVLT delayed recall: SMD = −1.12, 95% CI: −1.56 to −0.68). NMA revealed that the CI group (SUCRA = 0.89) was superior to the HA group (SUCRA = 0.62) and NI (SUCRA = 0.09) for preserving MoCA scores. Among the nine differentially expressed miRNAs identified in exploratory synthesis, three met strict quantitative criteria for NMA (reported in ≥2 independent studies with comparable quantification and variance data); hsa-miR-6875-5p was the most consistent biomarker (pooled FC = 1.52, 95% CI: 1.04–2.23), showing excellent agreement with sequencing data (FC = 3.29; ICC = 0.82, 95% CI: 0.67–0.91). Heterogeneity was significantly influenced by the miRNA detection platform (p = 0.04) and HL severity (p = 0.03). Conclusions: This study demonstrates that HL exacerbates cognitive decline in AD in a dose-dependent manner. Cochlear implants may offer superior cognitive protection compared to hearing aids. The consistently dysregulated hsa-miR-6875-5p emerges as a hypothesis-generating cross-modal biomarker, bridging clinical observation and molecular pathology in AD-HL comorbidity. Full article

Three-dimensional (3D) ear morphology is critical for the design of in-the-ear hearing aids, earphones, transcutaneous auricular vagus nerve stimulation (taVNS) electrodes, and auricular reconstruction, yet most existing ear shape models still rely on manually placed landmarks. Here, a fully annotation-free pipeline is presented for constructing a 3D ear atlas and statistical shape model (SSM) of the auricular bowl from 50 surface meshes. Individual ears are iteratively registered to a current atlas using rigid the iterative closest point (ICP) algorithm followed by a bidirectional thin-plate spline (BiTPS) deformation, and dense surface correspondences are established by nearest-neighbour mapping. Registration quality is quantified using mean and maximum nearest-neighbour distance, symmetric Chamfer-$L_2$ distance and coverage. Furthermore, SSM-derived bowl height and width are validated against manual 3D mesh measurements in Geomagic Design X. Across five atlas iterations, the BiTPS pipeline substantially reduces registration errors and increases coverage, and principal component analysis (PCA) derived dimensions show excellent agreement with manual measurements (Pearson $r\ge 0.98$, ICC $\ge 0.98$). The proposed framework yields a stable, anatomically plausible ear atlas and an interpretable low-dimensional SSM without manual landmarks, providing a computational basis for the geometric optimization of ear-related medical and wearable devices. Full article

Background/Objectives: Speech perception is measured in quiet and in the presence of background noise, such as multi-talker babble (MTB), to establish cochlear implant (CI) candidacy and measure post-operative outcomes. Testing protocols often use interrupted noise that begins just before and ends shortly after the target sentence, providing insufficient time for the noise-reduction algorithms to activate in the hearing device and provide an improved signal-to-noise ratio (SNR). Furthermore, interrupted noise does not allow the hearing-impaired user to acclimatize to the abrupt onset of noise or to focus on the target sentence, a challenge related to auditory stream segregation. The present study compares speech perception in bimodal CI users across interrupted and continuous MTB noise conditions to highlight performance differences between these two distinct listening environments. Methods: Speech perception was evaluated for two different bimodal CI groups. Group 1: This group evaluated an automatic hearing aid program across three environments: quiet, continuous MTB, and interrupted MTB. Group 2: This group evaluated two manual hearing aid programs across the same three environments (quiet, continuous, and interrupted MTB). Results: For Group 1, scores in quiet reached 88%, significantly declined in interrupted MTB (38%), but improved in continuous MTB (67%). For Group 2, no significant mean differences were found between interrupted and continuous noise across the two manual programs, though individual variations persisted. Conclusions: Based on the findings of this study, continuous noise rather than interrupted noise should be utilized for establishing CI candidacy and evaluating post-implantation speech perception. Full article

Background: Sensorineural hearing loss represents a significant global health burden affecting over 1.5 billion individuals worldwide. Modern hearing aids, equipped with digital signal processing and smart connectivity features, constitute a cornerstone of neuro-sensory rehabilitation. However, the psychosocial impact of these assistive smart technologies on patient self-esteem remains incompletely characterized. Methods: A cross-sectional multivariate study was conducted with 245 participants, divided into three groups: normal-hearing controls (NH, n = 73), hearing-impaired patients using smart hearing aid technology (HA users, n = 86), and hearing-impaired patients not using hearing aid technology (HA non-users, n = 86). Self-esteem was measured using the Rosenberg Self-Esteem Scale (SES). Hearing disability and tinnitus severity were assessed with the Hearing Handicap Inventory for Adults (HHIA) and Tinnitus Handicap Inventory (THI), respectively. Data analysis included one-way ANOVA, Tukey’s HSD post hoc tests, Pearson correlations, and multivariate regression. Results: Hearing aid users showed significantly higher SES scores (35.41 ± 5.32) compared to non-users (22.99 ± 4.53; p < 0.001, Cohen’s d = 2.515). One-way ANOVA indicated highly significant differences among groups (F = 299.00, p < 0.001, η² = 0.712). SES was negatively correlated with HHIA (r = −0.573, p < 0.001) and THI (r = −0.443, p < 0.001), while HHIA and THI were strongly positively correlated (r = 0.729, p < 0.001). In multivariate analysis, HA use remained a strong independent predictor of self-esteem (β ≈ 11.9, p < 0.001), even after adjustment for age, sex, HHIA, and THI. Perceived hearing handicap was independently associated with lower self-esteem, whereas tinnitus severity was not a significant predictor in the fully adjusted model. The model explained approximately 65% of the variance in self-esteem scores. Conclusions: Smart hearing-aid use is strongly and independently associated with higher self-esteem in patients with sensorineural hearing loss. These results support the inclusion of modern audiological rehabilitation devices in comprehensive management strategies for long-term conditions and highlight psychosocial benefits that extend beyond hearing restoration. Full article

Millions of persons worldwide experience varying degrees of hearing loss, traditionally addressed through prosthetic solutions such as hearing aids and cochlear implants. However, a significant proportion of individuals cannot benefit from these technologies, cannot access them, or choose not to use them. In this context, non-prosthetic assistive technologies have emerged as a complementary paradigm, leveraging advances in sensing, artificial intelligence, and wearable computing to transform acoustic information into alternative perceptual representations rather than restoring auditory function. This survey provides a review of such systems, focusing on technologies that enhance environmental awareness, communication, and social interaction. Existing approaches are categorized along two main dimensions: the tasks they perform and the platforms on which they operate. Task-oriented analysis includes sound recognition (speech and non-speech), sound source localization, emotion recognition, sign language recognition, and related emerging functionalities. Platform-based analysis emphasizes wearable devices and mobile solutions enabling real-time and context-aware assistance. The survey further highlights key research trends, including real-time auditory scene analysis, portable processing, and artificial intelligence. It shows that recent studies increasingly demonstrate that combining auditory, visual, and haptic modalities improves robustness and usability in real-world conditions, particularly in noisy and dynamic environments. Finally, open challenges such as energy efficiency, latency, evaluation methodologies, and user acceptance are discussed. By synthesizing existing work and identifying open research directions, this survey aims to provide a structured foundation for future developments in intelligent, non-prosthetic assistive systems that redefine how auditory information is accessed and interpreted. Full article

Introduction: The present study aimed to compare cortical auditory maturation, as reflected by P1 latency of cortical auditory evoked potentials (CAEPs), in children with congenital severe-to-profound sensorineural hearing loss rehabilitated with unilateral cochlear implants (CIs) or bilateral conventional hearing aids (HAs). Materials and Methods: Eighty-five children with congenital severe-to-profound sensorineural hearing loss were included in this retrospective comparative study. Participants were divided into two groups: unilateral CI users (n = 42) and bilateral HA users (n = 43). All children were fitted with their devices before 48 months of age and achieved aided free-field thresholds between 30 and 50 dB HL. CAEPs were recorded using the Fonix^® HEARLab System with speech stimuli (/m/, /g/, /t/) presented at 55 dB SPL. P1 latency values were measured and compared between groups using independent samples t-tests. Correlation analyses were performed to assess the relationship between duration of device use and P1 latency. Results: Eighty-five children were included (CI: n = 42; HA: n = 43). Mean P1 latency values did not differ significantly between groups for the /m/ stimulus (126.4 ± 29.13 ms vs. 126.4 ± 29.28 ms, p = 1.00), /g/ stimulus (106.5 ± 26.46 ms vs. 110.1 ± 29.49 ms, p = 0.55), or /t/ stimulus (114.7 ± 22.93 ms vs. 118.5 ± 27.19 ms, p = 0.48). Age at device fitting was comparable between groups (27.95 ± 9.10 vs. 26.88 ± 14.15 months, p = 0.68). The duration of device use was significantly longer in the HA group (48.02 ± 28.39 months) compared to the CI group (26.00 ± 15.92 months) (p < 0.001). Correlation analysis revealed no significant association between duration of device use and P1 latency for any stimulus (/m/: p = 0.28; /g/: p = 0.17; /t/: p = 0.09). Conclusions: When devices were fitted before 48 months of age and aided thresholds were optimized, unilateral cochlear implantation and bilateral conventional hearing aids showed comparable P1 latency values as an index of cortical auditory maturation. These findings suggest that early and adequate auditory stimulation may play an important role in supporting cortical auditory development in children with congenital hearing loss, although results should be interpreted within the context of individualized clinical management. Full article

Introduction: This study aimed to systematically assess the impact of hearing interventions on cognitive function in older adults with presbycusis. Methods: A comprehensive search was conducted across PubMed, EMBASE, and Web of Science databases from their inception to 22 June 2025 to identify eligible randomized clinical trials or cohort studies that used designated cognitive scales or cognitive test measures. Two separate meta-analyses were conducted: one using uncontrolled pre–post comparisons and another restricted to studies that included concurrent untreated control groups. Results: A total of 22 studies were identified, comprising 9 focused on hearing aid use and 13 on cochlear implantation. Ultimately, 19 studies were included in the quantitative analysis: 7 on hearing aid use and 12 on cochlear implantation. The pooled analysis of hearing intervention across 17 studies involving 1562 patients indicated a 4% improvement in cognitive test scores post-intervention compared with pre-intervention (ratio of means: 1.04; 95% CI: 1.03–1.05; p < 0.001). However, in the 4 controlled studies that included an untreated comparator group (815 intervention, 7450 control participants), hearing intervention did not confer a statistically significant cognitive benefit over no intervention (SMD = 0.03; 95% CI: −0.04 to 0.09; p = 0.369). Conclusions: Current controlled evidence does not support the claim that hearing interventions preserve or enhance cognitive function in older adults with presbycusis. Full article

Background: This study investigates the impact of initial head position prior to stimulus presentation on sound localization accuracy in children. The quadratic angular root mean square error (RMSE) and the linear mean-absolute-error (MAE) have been considered for this study. Material and Methods: A total of 28 normal-hearing children (ages 6–10) participated in sound localization. The participants localized sounds presented from five speakers at the frontal semicircle. Head positions at stimulus onset were tracked using glasses with a built-in webcam. The localization results were analyzed with and without correcting for the offset from the frontal direction of the initial head position prior to stimulus presentation. Results: The initial head position prior to stimulus presentation significantly affected the RMSE but had no influence on the MAE. This effect was stronger in younger children. The MAE showed fewer changes in head position due to its linear nature, which reduces the effect of large errors. An analysis of the children’s initial head positions revealed a tendency to deviate from the frontal direction. Therefore, the initial head position prior to stimulus presentation should be considered when calculating localization measures. Conclusions: The initial head position prior to a stimulus can distort the RMSE in directional hearing tests for children, while the MAE remains robust against such deviations. Full article

Objectives: This data-driven study aimed to explore the characteristics and initial hearing aid (HA) fitting parameters among older adults in Mainland China. Methods: Data were extracted from Oticon’s internal database, focusing on 82,834 older adults aged 55 or above who sought HAs for the first time. Results: Demographic details (e.g., age and gender), hearing-related data (e.g., the severity of hearing loss), and HA parameters (i.e., laterality of fitting, HA style, earpieces, gain settings, directionality settings, and noise reduction settings) were analyzed. The mean age was 71. There were more males (54.7%) than females, and the majority (78.1%) had at least moderately severe hearing loss. Bilateral fittings were common (76.6%), with receiver-in-canal (RIC) HAs being the dominant style (80%) and open fittings prevalent (44.1%). HA gain was set to below prescribed targets, along with adaptive directionality (93.4%) and low noise reduction levels (>68%). Conclusions: These findings offer insights into the Chinese hearing healthcare market. Future research should incorporate data from follow-up sessions to provide a more comprehensive understanding of the landscape, such as adjustments needed after initial fitting after first-time users have spent some time adapting to the use of HAs. Full article

Background: Age-related hearing loss (ARHL) is the most common sensory disorder in older adults and has been identified as a potentially modifiable risk factor for cognitive decline and dementia. Increasing evidence suggests that auditory dysfunction may contribute to adverse cognitive trajectories through multiple interacting pathways. This narrative review examines the mechanisms underlying the association between ARHL and cognitive decline, evaluates the impact of hearing rehabilitation, and discusses future research priorities. Methods: A narrative synthesis of epidemiological, neurobiological, and interventional studies was conducted, with emphasis on longitudinal cohort studies, neuroimaging research, and clinical investigations of hearing aids (HAs) and cochlear implants (CIs). Results: ARHL is consistently associated with accelerated cognitive decline and increased dementia risk. Proposed mechanisms include sensory deprivation-related cortical reorganization, increased cognitive load during effortful listening, shared neuropathological processes, and social disengagement. Neuroimaging studies demonstrate structural and functional alterations in auditory and associative brain regions in individuals with hearing loss. Emerging evidence suggests that HA and CI may improve cognitive performance and potentially attenuate decline, although long-term randomized data remain limited. Conclusions: Current evidence supports ARHL as a clinically relevant and potentially modifiable contributor to cognitive decline. Clarifying causal pathways and optimizing early hearing rehabilitation strategies represent key priorities for future dementia prevention research. Full article

Background/Objectives: Childhood hearing loss (HL) affects auditory, linguistic, and social development. Alongside conventional rehabilitation, music-based interventions have gained increasing attention for their potential to support both auditory and non-auditory domains. This narrative review aims to summarize current evidence on the use of music-based interventions in children with HL. Methods: A narrative review of the literature was conducted, examining studies involving pediatric cochlear implant or hearing aid users. Publications were categorized into three main areas: musical auditory perception, musical training, and music therapy. Results: Studies on musical auditory perception demonstrate persistent limitations in pitch and timbre perception in children with HL, while rhythmic abilities appear relatively preserved. Musical training interventions, particularly those targeting rhythm, have been associated with improvements in auditory perception, linguistic processing, and selected cognitive skills, although parental involvement and long-term designs remain limited. Existing literature on music therapy is scarce but suggests potential benefits extending beyond auditory skills to emotional regulation, social interaction, and quality of life. Conclusions: Music-based interventions represent a promising complementary approach in pediatric hearing rehabilitation. While musical training is more widely studied, music therapy is still underrepresented despite its holistic focus. Further structured studies are needed to define standardized protocols and outcome measures for music therapy in children with HL. Full article

Hearing loss is detrimental to human health, and currently, more than 1.5 billion people are affected by hearing loss. Active military personnel and construction workers are examples of individuals in the workplace who are exposed to loud noise and are at serious risk of hearing loss. While there is currently no therapy for hearing loss, evidence supports investigating the enhancement of the Medial Olivocochlear (MOC) system, an efferent pathway for hearing that serves as a gain-control for hearing loss protection. Selectively modulating the α9α10 nicotinic acetylcholine receptor (nAChRs) found within this pathway is promising for the development of a new drug class. In this review article, we present the most current findings related to the therapeutic targeting of α9α10 nAChRs for hearing loss. We discuss the loss- or gain-of-function of the receptor, evaluate the known modulators of the receptor, examine their clinical relevance, and discuss their chemical and physical properties. Investigation of this novel pathway may aid in the development of a therapeutic for hearing loss. Full article

Background: Active middle ear implants (AMEIs) provide an alternative auditory rehabilitation strategy for patients who cannot tolerate conventional hearing aids. However, clinical data regarding the outcomes of Vibrant Soundbridge (VSB) implantation using the incus short process (SP) coupler in older adults remain limited. Objective: This study aimed to evaluate the audiological outcomes, patient-reported hearing benefits, tinnitus improvement, and surgical safety of VSB implantation using the SP coupler in older adults with bilateral sloping sensorineural hearing loss. Methods: This retrospective study included 45 older male veterans (mean age 76.1 ± 5.3 years) with bilateral sloping sensorineural hearing loss who underwent unilateral VSB implantation with the SP coupler between 2019 and 2023. Functional hearing gain was assessed using preoperative and postoperative sound-field pure-tone thresholds. Patient-reported outcomes were evaluated using the Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Tinnitus Handicap Inventory (THI). Operative characteristics and postoperative complications were also analyzed. Results: Mean operative time was 40.2 ± 8.7 min. Functional hearing gain increased progressively across speech-critical frequencies, reaching +20 dB at 2 kHz and +30 dB at 4 kHz. The mean four-frequency pure tone average improved from 57.4 ± 8.3 dB HL preoperatively to 35.6 ± 6.9 dB HL postoperatively (p < 0.001). All SSQ subdomains showed significant improvement (p < 0.001). THI scores decreased significantly from 43.2 ± 8.4 to 17.1 ± 6.2 (p < 0.0001), with clinically meaningful tinnitus improvement observed in 75.6% of patients. No major surgical complications occurred. Conclusions: Vibrant Soundbridge implantation using the incus short process coupler provides effective auditory rehabilitation for older adults with sloping sensorineural hearing loss. The procedure yields meaningful high-frequency hearing gain, improved hearing-related quality of life, and significant tinnitus reduction while maintaining a favorable surgical safety profile. Restoration of auditory input through active middle ear implantation may also contribute to improved central auditory processing in older adults. Full article