Audiol. Res., Volume 14, Issue 3 (June 2024) – 7 articles

In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer’s disease is discussed, with the aim of enhancing our understanding of these interconnected conditions. Highlighting the evolving significance of audiologists in the dual management of cognitive health and hearing impairments, the author focuses on their role in identifying early signs of cognitive impairment and evaluates various cognitive screening tools used in this context. The discussion extends to adaptations of hearing assessments for older adults, especially those diagnosed with dementia, and highlights the significance of objective auditory electrophysiological tests. These tests are presented as vital in assessing the influence of aging and Alzheimer’s disease on auditory processing capabilities and to signal cognitive dysfunction. The article underscores the critical role of audiologists in addressing the challenges faced by the aging population. The perspective calls for further research to improve diagnostic and therapeutic strategies in audiology, and emphasizes the need for a multidisciplinary approach in tackling the nexus of hearing loss, auditory processing, and cognitive decline. Full article

The use of remote testing to collect behavioral data has been on the rise, especially after the COVID-19 pandemic. Here we present psychometric functions for a commonly used speech corpus obtained in remote testing and laboratory testing conditions on young normal hearing listeners in the presence of different types of maskers. Headphone use for the remote testing group was checked by supplementing procedures from prior literature using a Huggins pitch task. Results revealed no significant differences in the measured thresholds using the remote testing and laboratory testing conditions for all the three masker types. Also, the thresholds measured obtained in these two conditions were strongly correlated for a different group of young normal hearing listeners. Based on the results, excellent outcomes on auditory threshold measurements where the stimuli are presented both at levels lower than and above an individual’s speech-recognition threshold can be obtained by remotely testing the listeners. Full article

This study aimed to compare the Hebrew version of the digits-in-noise (DIN) thresholds among cochlear implant (CI) users and their normal-hearing (NH) counterparts, explore the influence of age on these thresholds, examine the effects of early auditory exposure versus its absence on DIN threshold, and assess the correlation between DIN thresholds and other speech perception tests. A total of 13 children with CI (aged 5.5–11 years), 15 pre-lingual CI users (aged 14–30 years), and 15 post-lingual CI users (aged 22–77 years), and their age-matched NH controls (n = 45) participated in the study. Speech perception tasks, including the DIN test, one-syllable word test, and sentence identification tasks in various auditory conditions, served as the main outcome measures. The results indicated that CI users exhibited higher speech reception thresholds in noise across all age groups compared to NH peers, with no significant difference between pre-lingual and post-lingual CI users. Significant differences were also observed in monosyllabic word and sentence accuracy in both quiet and noise conditions between CI and NH groups. Furthermore, correlations were observed between the DIN and other speech perception tests. The study concludes that CI users require a notably higher signal-to-noise ratio to discern digits in noise, underscoring the DIN test’s utility in assessing speech recognition capabilities in CI users while emphasizing the need for a comprehensive test battery to fully gauge their speech perception abilities. Full article

Hyperventilation induces metabolic changes that can elicit nystagmus (hyperventilation-induced nystagmus, HVIN) in various vestibular disorders, revealing vestibular imbalance and bringing out central or peripheral asymmetries. In acute unilateral vestibulopathy (AUVP, namely vestibular neuritis), hyperventilation can induce different patterns of nystagmus (excitatory, inhibitory, or negative), disclosing or modifying existing static vestibular asymmetries through its ability to invalidate compensation or increase peripheral excitability. In this context, we followed the evolutionary stages of HVIN in AUVP across 35 consecutive patients, with the goal of assessing alterations in the oculomotor pattern caused by hyperventilation over time. In the acute phase, the incidence of the excitatory pattern (and the strongly excitatory one, consisting of a reversal nystagmus evoked by hyperventilation) was significantly higher compared to the inhibitory pattern; then, a progressive reduction in the incidence of the excitatory pattern and a concomitant gradual increase in the incidence of the inhibitory one were observed in the follow-up period. Assuming the role of the ephaptic effect and the transient loss of vestibular compensation as opposing mechanisms, i.e., excitatory and inhibitory, respectively, the oculomotor pattern evoked by hyperventilation is the result of the interaction of these two factors. The data obtained allowed us to hypothesize an interpretative model regarding the pathogenetic aspects of responses evoked by hyperventilation and the etiologies of the disease: according to our hypotheses, the excitatory pattern implies a neuritic (viral) form of AUVP; instead, the inhibitory (and negative) one can be an expression of both the neuritic (viral) and vascular forms of the disease. Full article

(1) Background: Patients affected by Ménière’s disease can experience Tumarkin’s syndrome, which is characterized by postural instability, gait abnormalities, and, occasionally, an abrupt loss of balance known as vestibular drop attack or Tumarkin’s crisis. In this study, semicircular canal plugging is proposed as the definitive treatment for this condition. The outcomes of this type of surgery are discussed. (2) Methods: A total of 9 patients with a confirmed diagnosis of Ménière disease suffering from Tumarkin crisis underwent posterior semicircular canal plugging. These patients were assessed with Video Head Impulse Tests, vestibular evoked myogenic potentials, and Pure Tone Audiometry preoperatively and postoperatively. (3) Results: VHIT showed a postoperative decrease in PSC gain median (Preop. 0.86 and postop. 0.52; p < 0.009). No statistically significant differences were described for the anterior semicircular canal and the lateral semicircular canal. No patient experienced new Tumarkin crisis after the surgical treatment. (4) Conclusions: Our ten years of experience with posterior semicircular canal plugging in Ménière disease patients with Tumarkin’s syndrome has shown that this type of surgical procedure is successful in controlling Tumarkin’s crisis, with high patient satisfaction and little worsening in hearing level. Full article

Background: Cognitive behavioural therapy (CBT) for tinnitus management is effective and widely recommended by national and international practice guidelines. However, all the evidence for CBT so far has come from Psychologist-led programs, and the potential role of Audiologists in providing CBT for tinnitus remains an important consideration. Objectives: This study sets out to systematically map the body of literature relating to Audiologist-provided CBT for tinnitus, in order to summarise the current state of evidence and determine directions for future research. Eligibility criteria: Sources were eligible for inclusion if they addressed the concept of Audiologist-provided CBT. No restrictions were imposed on the date of publication. Only sources published in English were included. Sources of evidence: A wide range of primary and secondary literature sources were sought. Charting methods: Data from included sources were charted systematically using a pre-designed data charting form. Results: Of the 267 identified sources, 30 were included in this review. This included both primary and secondary literature sources. Primary sources were compared and showed variation across Audiologist-provided CBT programs both in terms of procedural details and from a research standpoint. Conclusions: A growing body of evidence has addressed the concept of Audiologist-provided CBT. Directions for future research include further primary research with an increased focus on face-to-face Audiologist-provided CBT, and a comparison of the outcomes of Audiologist-provided vs. Psychologist-provided CBT. Full article

Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European survey about this topic was conducted focusing on safety issues, and the results were compared with the current literature. We collected a total of 65 MRI scans performed in 9 otologic referral centers for a total of 47 Hires Ultra 3D recipients, including, for the first time, 2 children and 3 teenagers. Preventive measures were represented by scanning time and sedation for children. Head wrapping was used in eight cases, and six of the eight cases received local anesthesia, even if both measures were not needed. Only three patients complained of pain (3/65 examinations, 4.6%) due to the tight head bandage, and one of the three cases required MRI scan interruption. No other adverse events were reported. We believe that these results should encourage MRI execution in accordance with manufacturer recommendations for Ultra 3D recipients. Full article