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Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment

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A special issue of Audiology Research (ISSN 2039-4349).

Deadline for manuscript submissions: 30 April 2025 | Viewed by 13228

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Dr. George K. Psillas

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1st Academic ENT Department, Aristotle University of Thessaloniki, AHEPA Hospital, 546 36 Thessaloniki, Greece
Interests: hearing rehabilitation; middle and inner ear; ear surgery; cochlear implantation; auditory brainstem responses; facial nerve electrophysiology
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Special Issue Information

Dear Colleagues,

Hearing loss represents one of the most wide-ranging disabilities, affecting more than 5% of the world’s population. Different types of hearing loss, including conductive and sensorineural hearing loss, may lead to serious hearing impairments in children and adults. Multiple causes may be involved in the aetiopathogenesis of hearing loss, depending on the different biologic mechanisms, including congenital and autoimmune. Diagnosis and management continue to be a challenge for hearing disorders such as chronic otitis media, otosclerosis, cholesteatoma, congenital or acquired sensorineural hearing loss, sudden sensorineural or metabolic hearing loss, and otogenic facial palsy. Electrophysiology and neuroscience approaches are needed in order to better elucidate the diagnostic dilemmas in the field of otology and neurotology. New treatment options will be discussed to improve potential methods of hearing restoration.

We especially encourage submissions concerning hearing aids, cochlear/vestibular/auditory brainstem implantation, middle ear surgery, and stapedotomy:

age-related hearing loss
genes associated with hearing loss
speech perception testings
pathophysiologic patterns for hearing loss
neuroimaging for inner ear
electrophysiologic evaluation of hearing loss
surgery for hearing loss / cophosis

Dr. George K. Psillas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Audiology Research is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

genetics
speech perception
conductive hearing loss
sensorineural hearing loss
neuroimaging
electrophysiology
cochlear implants

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Published Papers (9 papers)

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Research

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13 pages, 721 KiB

Open AccessArticle

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Persian Version of the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (P-MARS-HA)

by Abdolhakim Jorbonyan, Yadollah Abolfathi Momtaz, Mahshid Foroughan and Saeideh Mehrkian

Audiol. Res. 2025, 15(2), 31; https://doi.org/10.3390/audiolres15020031 - 15 Mar 2025

Viewed by 233

Abstract

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

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

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9 pages, 741 KiB

Open AccessArticle

Multicenter Study on the Impact of the Masker Babble Spectrum on the Acceptable Noise Level (ANL) Test

by Mark Laureyns, Giorgia Pugliese, Melinda Freyaldenhoven Bryan, Marieke Willekens, Anna Maria Gasbarre, Diego Zanetti, Julien Gilson, Paul Van Doren and Federica Di Berardino

Audiol. Res. 2024, 14(6), 1075-1083; https://doi.org/10.3390/audiolres14060088 - 7 Dec 2024

Viewed by 807

Abstract

Introduction: Acceptable Noise Level (ANL) is defined as the most comfortable level (MCL) intensity for speech and is calculated by subtracting the maximum noise tolerable by an individual. The ANL test has been used over time to predict hearing aid use and the impact of digital noise reduction. This study analyzes this impact by using different masker babble spectra when performing the ANL test in both hearing-impaired and healthy subjects in three different languages (Dutch, French, and Italian). Materials and Methods: A total of 198 patients underwent the ANL test in their native language using a standardized protocol. The babble file was speech-weighted to match the long-term spectrum of the specific ANL language version. ANL was proposed in three different masking conditions: with multitalker Matched babble speech noise, with the same masking signal with the spectrum reduced from 2 kHz onwards (High Cut), and with the spectrum increased from 2 kHz onwards (High Boost). Results: In all of the comparisons among the three languages, ANL with High Boost noise gave significantly higher (worse) scores than ANL with Matched noise (p-value S1: <0.0001, S2: <0.0001, S3: 0.0003) and ANL with High Cut noise (p-value S1: 0.0002, S2: <0.0001, S3: <0.0001). The ANL values did not show any significant correlation with age and gender. In French, a weak correlation was found between ANL with High Cut noise and the Fletcher index of the worst ear. In Italian, a weak correlation was found between both ANL with Matched and High Boost noise and the Fletcher index of the best ear. Conclusions: ANL with High Boost added to noise stimuli was less acceptable for all patients in all of the languages. The ANL results did not vary in relation to the patients’ characteristics. This study confirms that the ANL test has potential application for clinical use regardless of the native language spoken. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

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15 pages, 2766 KiB

Open AccessArticle

Middle Ear Active Implant Indications, Comparative Audiometric Results from Different Approaches, and Coupling with the Vibrant Soundbridge^®: A Single Center Experience over More Than 20 Years

by Joan Lorente-Piera, Raquel Manrique-Huarte, Janaina P. Lima, Diego Calavia and Manuel Manrique

Audiol. Res. 2024, 14(4), 721-735; https://doi.org/10.3390/audiolres14040061 - 21 Aug 2024

Cited by 2 | Viewed by 1071

Abstract

Background: Middle ear active implants, such as the Vibrant Soundbridge (VSB), offer an alternative to reconstructive surgery and other implantable hearing aid systems for patients with conductive, mixed, or sensorineural hearing loss. The primary objective of this work is to describe the auditory results obtained with VSB in our patient cohort, measuring the auditory gain in terms of average tonal thresholds and spoken word discrimination at 65 dB. Secondly, auditory gain differences between different types of hearing loss, coupling to the ossicular chain compared to round and oval windows, and the impact of open versus more conservative surgical approaches, were analyzed. Methods: A cross-sectional observational study, with retrospective data collection, was conducted at a tertiary care center. Clinical and audiometric data pre- and post-implantation were included, from patients who underwent VSB device placement surgery between 2001 and 2024. Results: 55 patients with an average age of 62.58 ± 17.83 years and a slight preference in terms of the female gender (52.72%) were included in the study. The average gain in the PTA for all types of hearing loss was 41.56 ± 22.63 dB, while for sensorineural hearing loss (SNHL) the gain was 31.04 ± 8.80 dB. For mixed-conductive hearing loss (C-MHL) a gain of 42.96 ± 17.70 was achieved, notably, in terms of absolute values, at frequencies of 4000 and 6000 Hz, with gains reaching 49.25 ± 20.26 dB at 4 K and 51.16 ± 17.48 dB at 6 K. In terms of spoken word discrimination, for all types of hearing loss, an improvement of 75.20 ± 10.11% was achieved. However, patients with C-MHL exhibited an approximately 13% higher gain compared to those with SNHL (69.32 ± 24.58% vs. 57.79 ± 15.28%). No significant differences in auditory gain were found between open and closed surgical techniques, nor in the proportion of adverse effects, when comparing one technique with the other. Conclusions: The VSB is effective in improving hearing in patients with mixed, conductive, and sensorineural hearing loss, with significant gains at high frequencies, especially through the round window membrane approach. The choice of surgical technique should consider the patient’s anatomical characteristics and specific needs in order to optimize auditory outcomes and minimize postoperative complications. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

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15 pages, 1231 KiB

Open AccessArticle

Preliminary Validation of the Children’s Auditory Performance Scale (CHAPS) and the Auditory Processing Domain Questionnaire (APDQ) in Greek Cypriot Children

by Konstantinos Drosos, Dionysios Tafiadis, Louiza Voniati, Alexandra Papanicolaou and Chryssoula Thodi

Audiol. Res. 2024, 14(4), 625-639; https://doi.org/10.3390/audiolres14040053 - 15 Jul 2024

Cited by 1 | Viewed by 2078

Abstract

Background: Identification of auditory processing disorders is achieved using questionnaires along with linguistic, non-linguistic, and auditory processing tests. Notably, the questionnaires “Children’s Auditory Performance Scale” (CHAPS) and “Auditory Processing Domain Questionnaire” (APDQ) are widely recognized and used. The current study investigated the psychometric properties of the CHAPS and APDQ in Greek Cypriot children. Methods: The CHAPS and APDQ questionnaires were completed by parents of 40 Greek Cypriot children, 16 typically developing (TD) children, and 24 children with a history of Speech Sound Disorders (SSDs). Results: There were significant differences between the two groups on both questionnaires. Cronbach’s alpha was calculated at α = 0.922 for the CHAPS total score and α = 0.926 for the APDQ total score. The Receiver Operating Curve (ROC) analysis provided a cut-off point equal to −0.30 (AUC 0.849, p < 0.001) for CHAPS and a cut-off point equal to 90.00 (AUC 0.820, p < 0.001) for APDQ. Significant positive Spearman ρ correlations were observed between the CHAPS and APDQ (ρ = 0.639, p = 0.001). Conclusions: The CHAPS and APDQ can identify distinct auditory processing characteristics between in children with SSDs and TD children. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

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9 pages, 231 KiB

Open AccessArticle

Assessing the Effectiveness of Different Hyperbaric Oxygen Treatment Methods in Patients with Sudden Sensorineural Hearing Loss

by Paweł Rozbicki, Jacek Usowski, Sandra Krzywdzińska, Dariusz Jurkiewicz and Jacek Siewiera

Audiol. Res. 2024, 14(2), 333-341; https://doi.org/10.3390/audiolres14020029 - 29 Mar 2024

Cited by 2 | Viewed by 2037

Abstract

Introduction: Hyperbaric oxygen therapy (HBOT) is one of the treatment methods in patients with sudden sensorineural hearing loss (SSNHL). It is recommended as an elective treatment in patients undergoing steroid therapy. According to current scientific reports, HBOT should be implemented within two weeks after the first symptoms. However, as far as the profile of HBOT is concerned, there are no straightforward recommendations. Methods: The data obtained from the medical records of 218 patients undergoing HBOT for SSNHL at the Military Institute of Medicine—National Research Institute were analyzed statistically for the impact of the duration and the delay in implementing HBOT on the end results of pure-tone audiometry (PTA). Results: A statistically significant hearing improvement in patients undergoing more than 15 cycles of HBOT was detected at all frequencies except for 1500 Hz; in the group reporting for treatment with a delay of more than 10 days, hearing improvement was statistically unsignificant at frequencies of 1500, 3000, and 4000 Hz. Conclusions: The statistical analysis showed that the urgent onset of HBOT could be a significant factor in the therapy of SSNHL. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

11 pages, 1136 KiB

Open AccessArticle

Over-the-Counter (OTC) Hearing Aid Availability across the Spectrum of Human Skin Colors

by Shade Avery Kirjava and Sam Jones Faulkner

Audiol. Res. 2024, 14(2), 293-303; https://doi.org/10.3390/audiolres14020026 - 12 Mar 2024

Viewed by 1967

Abstract

Background: Over-the-counter (OTC) hearing aids were recently approved for sale in the United States. Research has shown that consumers prefer hearing devices that match their skin color because these devices are less noticeable. Colorism is discrimination against individuals with relatively darker skin that manifests in “skin-color” product offerings as products being offered primarily in relatively lighter colors. Methods: This study compared images of U.S. Food and Drug Administration (FDA)-registered over-the-counter hearing aids to a range of human skin colors. Results: Most over-the-counter hearing aids are only offered in relatively lighter beige colors. Few over-the-counter hearing aids are available in darker skin colors. Conclusions: These findings may represent structural bias, preventing equitable access to darker skin-color OTC hearing aids for individuals with darker skin. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

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13 pages, 7876 KiB

Open AccessArticle

Renewed Concept of Mastoid Cavity Obliteration with the Use of Temporoparietal Fascial Flap Injected by Injectable Platelet-Rich Fibrin after Subtotal Petrosectomy for Cochlear Implant Patients

by Aleksander Zwierz, Krystyna Masna, Paweł Burduk, Stephan Hackenberg and Matthias Scheich

Audiol. Res. 2024, 14(2), 280-292; https://doi.org/10.3390/audiolres14020025 - 1 Mar 2024

Cited by 1 | Viewed by 1690

Abstract

Background: The subtotal petrosectomy procedure may be useful for cochlear implantation in selected patient groups. Although it is highly effective, complications can arise, which may have economic implications for the patient due to the high cost of the device. Therefore, several authors have attempted to identify the most effective concept for obliteration. Methods: We present a pilot descriptive study of application techniques for obliterating cavities after subtotal petrosectomy using a temporoparietal fascial flap (TPFF) modified with injectable platelet-rich fibrin (IPRF+) for three cochlear implant (CI) patients. Results: Our concept preserves important anatomical structures, such as the temporalis muscle, which covers the CI receiver–stimulator. Injection of IPRF+ also increases the available tissue volume for obliteration and enhances its anti-inflammatory and regenerative potential. Conclusions: To the best of our knowledge, the use of TPFF for filling the cavity has not been adopted for CI with SP and for blind sac closure. Our literature review and our experience with this small group of patients suggest that this procedure, when combined with IPRF+ injections, may reduce the risk of potential infection in the obliterated cavity, particularly when used with CI. This technique is applicable only in cases when the surgeons are convinced that the middle ear cavity is purged of cholesteatoma. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

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Review

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18 pages, 315 KiB

Open AccessReview

Strategies to Mitigate Cisplatin-Induced Ototoxicity: A Literature Review of Protective Agents, Mechanisms, and Clinical Gaps

by Alexandru Orasan, Mihaela-Cristina Negru, Anda Ioana Morgovan, Razvan Claudiu Fleser, Daniela Sandu, Adrian Mihail Sitaru, Alexandru-Catalin Motofelea and Nicolae Constantin Balica

Audiol. Res. 2025, 15(2), 22; https://doi.org/10.3390/audiolres15020022 - 27 Feb 2025

Viewed by 302

Abstract

Background: Cisplatin, a widely used chemotherapeutic agent, is associated with significant ototoxicity, leading to progressive and irreversible sensorineural hearing loss in up to 93% of patients. Cisplatin generates reactive oxygen species (ROS) in the cochlea, activating apoptotic and necroptotic pathways that result in hair cell death. Inflammatory processes and nitrative stress also contribute to cochlear damage. Methods: This literature review was conducted to explore the mechanisms underlying cisplatin-induced ototoxicity and evaluate protective strategies, including both current and emerging approaches. A structured search was performed in multiple scientific databases, including PubMed and ScienceDirect, for articles published up to November 2024. Results: Current otoprotective strategies include systemic interventions such as antioxidants, anti-inflammatory agents, and apoptosis inhibitors, as well as localized delivery methods like intratympanic injection and nanoparticle-based systems. However, these approaches have limitations, including potential interference with cisplatin’s antitumor efficacy and systemic side effects. Emerging strategies focus on genetic and biomarker-based risk stratification, novel otoprotective agents targeting alternative pathways, and combination therapies. Repurposed drugs like pravastatin also show promise in reducing cisplatin-induced ototoxicity. Conclusions: Despite these advancements, significant research gaps remain in translating preclinical findings to clinical applications and developing selective otoprotective agents that do not compromise cisplatin’s efficacy. This review examines the mechanisms of cisplatin-induced ototoxicity, current otoprotective strategies, and emerging approaches to mitigate this adverse effect. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

11 pages, 728 KiB

Open AccessReview

Congenital Cytomegalovirus-Related Hearing Loss

by Nicoleta Gana, Iulia Huluță, Mihai-Ștefan Cătănescu, Livia-Mihaela Apostol, Florina Mihaela Nedelea, Romina-Marina Sima, Radu Botezatu, Anca Maria Panaitescu and Nicolae Gică

Audiol. Res. 2024, 14(3), 507-517; https://doi.org/10.3390/audiolres14030043 - 16 Jun 2024

Cited by 2 | Viewed by 1852

Abstract

Congenital hearing loss is a significant global health concern that affects millions of newborns and infants worldwide, posing substantial challenges for affected individuals, their families, and healthcare systems. This condition, present at birth, can stem from genetic factors, in utero exposures, infections, or complications during pregnancy or childbirth. The spectrum of congenital hearing loss ranges from mild to profound, impacting the development of speech, language, and cognitive skills, thereby influencing educational achievements, social integration, and future employment opportunities. Early detection and intervention strategies, such as newborn hearing screenings, genetic counseling, and the use of hearing aids or cochlear implants, are crucial for mitigating these impacts. This review article aims to explore the diagnostic approaches and management strategies for congenital cytomegalovirus-related hearing loss, emphasizing the importance of interdisciplinary care and the potential for technological advances to improve outcomes for affected individuals. Full article

(This article belongs to the Special Issue Hearing Loss: Causes, Symptoms, Diagnosis, and Treatment)

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