Search Results (1,082)

Background: Superior semicircular canal dehiscence (SSCD) is characterized by a bony defect of the superior semicircular canal (SSC), leading to vestibular and auditory symptoms. A process of spontaneous “auto-plugging,” in which the overlying dura mater progressively occludes the SSC, may replicate the effects of surgical canal plugging but remains under-recognized. The present study reports diverse clinical, instrumental, and 3d High Resolution MRI findings in patients with SSCD and subsequently confirmed to present with spontaneous complete or partial auto-plugging. Methods: We retrospectively reviewed 11 patients with SSCD diagnosed on high-resolution CT and suspected auto-plugging based on clinical atypia and large dehiscence (>4 mm). Patients underwent comprehensive neurotological assessment, including pure-tone audiometry, vestibular testing, and HR MRI with 3D labyrinthine reconstructions to identify partial or complete auto-plugging. Auto-plugging was classified as partial (Canalis semicircularis superior depressus) or complete (absence of endolymph fluid signal; Canalis semicircularis superior obturatus). Results: Among 13 ears with auto-plugging, 6 were partial and 7 complete. The mean SSCD size in auto-plugged ears was 5.5 mm. Most ears had normal or near-normal vestibular function on VHIT, with minimal air-bone gaps and preserved VEMP responses. Imaging demonstrated varying degrees of dural contact with the SSC, confirming partial or complete canal occlusion. Conclusions: Spontaneous auto-plugging of the SSC is a plausible, under-recognized phenomenon that may reproduce functional effects of surgical plugging. Dedicated 3D labyrinthine MRI enhances detection and characterization. Prospective multimodal studies are needed to clarify the pathophysiology, progression, and clinical implications, optimizing patient selection for surgical versus conservative management. Full article

Background/Objectives: Mobile health (mHealth) tools, such as smartphone apps, support person-centred care for persons with hearing loss engaging in the hearing aid management process. Hearing-aid-connected apps are increasingly common in audiological care, making it important to evaluate their availability and quality for clinicians, developers, and end-users. This scoping review aimed to identify, summarize, and synthesize information on clinically available hearing-aid-connected apps and evaluate their quality. Methods: A search of the Apple App Store (Canada) was conducted in August 2024 to identify current hearing-aid-connected apps that support hearing aid management. Metadata and features were extracted, and app quality was assessed using the Mobile Application Rating Scale (MARS). Quality was assessed across four objective domains (engagement, functionality, aesthetics, and information) and one subjective domain. Results: Apps had varying levels of metadata detail, including updates, compatibility, and target populations. All apps included common hearing aid controls (e.g., volume adjustment, microphone directionality), while more specialized features (tinnitus management, health tracking, remote clinician support) varied. High-performing apps scored significantly higher in engagement, functionality, aesthetics, and subjective quality, and all apps scored low in information quality, particularly for evidence and credibility. Conclusions: Findings highlight the need for transparent and informative metadata reporting and patient-centred design to improve clinical awareness, usability, and uptake of hearing-aid-connected apps. Full article

Background/Objectives: Swallowing and speech rely on shared brainstem circuits coordinating oropharyngeal motor functions. In neurodegenerative diseases affecting the brainstem—such as progressive supranuclear palsy (PSP), amyotrophic lateral sclerosis (ALS), and multiple system atrophy (MSA)—bulbar dysfunction often impairs tongue propulsion and motility, affecting both swallowing (dysphagia) and phonation (dysarthria). This study aimed to investigate whether vowel-based acoustic features are associated with swallowing severity in brainstem-related disorders and to explore their potential as surrogate markers of bulbar involvement. Methods: This was a cross-sectional observational study. Thirty-one patients (13 PSP, 12 ALS, 6 MSA) underwent clinical dysarthria assessment, acoustic analysis of the first (F1) and second (F2) formants during sustained phonation of /a/, /i/, /e/, and /u/, and swallowing evaluation using standardized clinical scales (DOSS, FOIS, ASHA-NOMS) and fiberoptic endoscopic evaluation (Pooling Score, Penetration-Aspiration Scale). The vowel space area (tVSA, qVSA) and Formant Centralization Ratio (FCR) were computed. Results: Significant correlations emerged between acoustic vowel metrics and dysphagia severity, especially for liquids. The FCR showed strong correlations with DOSS (ρ = −0.660, p < 0.0001), FOIS (ρ = −0.531, p = 0.002), ASHA-NOMS (ρ = −0.604, p < 0.0001), and instrumental scores for liquids: the Pooling Score (ρ = 0.538, p = 0.002) and PAS (ρ = 0.630, p < 0.0001). VSA measures were also associated significantly with liquid swallowing impairment. F2u correlated with dysarthria severity and all liquid-related dysphagia scores. Conclusions: Vowel-based acoustic parameters, particularly FCR and F2u, reflect the shared neuromotor substrate of articulation and swallowing. Acoustic analysis may support early detection and monitoring of bulbar dysfunction, especially where instrumental assessments are limited. Full article

Background/Objectives: Cochlear implants (CIs) are a common treatment of severe-to-profound hearing loss and provide reasonable speech understanding, at least in quiet situations. However, their limited spectro-temporal resolution restricts sound quality, which is especially crucial for music appraisal. Many CI recipients wear a hearing aid (HA) on the non-implanted ear (bimodal users), which may enhance music perception by adding acoustic fine structure cues. Since it is unclear how the HA should be fitted in conjunction with the CI to achieve optimal benefit, this study aimed to systematically vary HA fitting parameters and assess their impact on music sound quality in bimodal users. Methods: Thirteen bimodal CI recipients participated in a listening experiment using a master hearing aid that allowed controlled manipulation of HA settings. Participants evaluated three music excerpts (pop with vocals, pop without vocals, classical) using the multiple-stimulus with hidden reference and anchor (MUSHRA) test. To assess the reliability of individual judgments, each participant repeated the test, and responses were analyzed with the eGauge method. Results: Most participants provided reliable and consistent sound quality ratings. Compared to a standard DSL v5.0 prescriptive fitting, modifications in compression settings and low-frequency gain significantly influenced perceived music quality. The effect of low-frequency gain adjustments was especially pronounced for pop music with vocals, indicating stimulus-dependent benefits. Conclusions: The study demonstrates that HA fitting for bimodal CI users can be optimized beyond standard prescriptive rules to enhance music sound quality by increasing low-frequency gain, particularly for vocal-rich pieces. Additionally, the testing method shows promise for clinical application, enabling individualized HA adjustments based on patient-specific listening preferences, hence fostering personalized audiology care. Full article

The brainstem plays a pivotal role in the generation and control of eye movements—including saccades, smooth pursuit, the vestibulo-ocular reflex (VOR), vergence, and gaze holding. Beyond its vital physiological functions, it is also essential for the coordination of balance and movement. Consequently, eye movement disorders of brainstem origin are often accompanied by vertigo, imbalance, unsteady gait, and diplopia, particularly during changes in head or body position. A sound understanding of the neural structures involved in oculomotor and vestibular control is therefore crucial for accurately identifying and localizing a wide variety of brainstem syndromes. However, oculomotor abnormalities resulting from brainstem disease represent a major diagnostic challenge for the neurotologist, owing to the wide spectrum of possible etiologies (vascular, traumatic, degenerative, neoplastic), their variable severity and clinical course (acute, fluctuating, or progressive), and the frequent concomitant involvement of other central structures, particularly the cerebellum. This mini review summarizes the pathophysiological mechanisms and clinical features of oculomotor disorders and nystagmus associated with brainstem disease. Full article

Background/Objectives: Tinnitus is a complex auditory phenomenon with multifactorial origins, often involving both peripheral and central auditory pathways. Given the multifactorial nature of tinnitus, this review specifically focuses on the auditory brainstem as it represents the first central relay for auditory input and a key site of abnormal synchrony and central gain, which may generate or modulate tinnitus even when peripheral hearing appears normal. Several studies suggest a potential role of brainstem dysfunction in its pathogenesis, even among patients with normal hearing thresholds. Although the physiopathological data provide evidence for the role of brainstem in the generation and magnification of tinnitus, the diagnostic tools are still unclear. This systematic review aimed to investigate the diagnostic relevance of brainstem-level abnormalities in individuals with tinnitus. Methods: Following PRISMA guidelines, a literature search was conducted using PubMed, Scopus, and Web of Science from January 2000 to June 2025. Studies were included if they addressed the diagnostic relationship between tinnitus and brainstem involvement. Data on auditory brainstem response (ABR), otoacoustic emissions (used to differentiate peripheral from central auditory abnormalities), neuroimaging, and electrophysiological markers were extracted. Results: Twenty studies were included. Most used ABR as a diagnostic tool, revealing significant amplitude and latency alterations in tinnitus patients compared to controls, particularly in wave V and V/I amplitude ratios. Imaging studies supported altered brainstem–cortical connectivity and localized changes in inferior colliculus (IC) activity. Additional techniques, such as middle-latency evoked potentials and gap-in-noise detection, showed potential but lacked consistent clinical utility. Conclusions: Evidence suggests that brainstem dysfunction may contribute to tinnitus generation or persistence. ABR and advanced imaging represent specific diagnostic tools, though standardization and high-quality studies are still needed to improve clinical applicability. Full article

Background: Serotonin (5-HT) is a neurotransmitter and a hormone that regulates various functions. Serotonin receptors have been studied in animal experiments in the vestibular system, beginning from the inner ear and vestibular nuclei. However, the role of serotonin in the vestibular system and disorders remains to be clarified. Methods: A review of the literature was performed on different databases according to the PRISMA guidelines. Only publications published on humans and in English have been included. A total of 41 articles were included in this review. Results: There are many publications regarding the use of SSRI/SNRI in vestibular disorders. Regarding persistent postural perceptual dizziness (PPPD) and chronic subjective dizziness (CSD) the available evidence supports multimodality treatment incorporating vestibular rehabilitation, serotonergic medications, and cognitive behavior therapy, although most studies have not included a placebo control group. As for vestibular migraine (VM), SNRI and SSRIs were proposed as preventive therapy and demonstrated a reduction in vertigo attacks in patients with Menière’s Disease (MD), especially when symptoms of anxiety disorder were present. Conclusions: Although SSRIs/SNRIs are considered an off-label therapy for vertigo, several studies have assessed their efficacy in vestibular disorders, as indicated in the data published on PPPD, MD, and VM above all. As some studies report that serotonin receptors are also present in the inner ear and vestibular nuclei, it can be postulated that in cases where the natural levels of serotonin are altered, such as in depression and anxiety, the change in serotonin levels may affect vestibular function and play a role in vestibular disorders. Full article

Background and Clinical Significance: developmental language disorder (DLD) and specific learning disorder (SLD) may coexist, resulting in significantly broader impairments to oral and written language skills. Understanding the neurobiological basis of these deficits is crucial, and electrophysiological assessment of the auditory system offers an objective approach not influenced by behavioral factors. The present study describes the audiological electrophysiology of an adolescent diagnosed with both DLD and SLD. Case Presentation: R.B., a 15-year-old adolescent with a history of SLD and DLD, presented with persistent deficits in oral language (syntax) and written (decoding) skills after 7 months of intensive therapy. Basic audiological tests confirmed hearing within normal limits. An electrophysiological battery, including the click-brainstem auditory evoked potential (c-ABR), medium latency auditory evoked potential (MLAEP), long-latency auditory evoked potential (P300), and frequency following response (FFR), was performed to investigate information processing in the auditory trajectory. The c-ABR confirmed the integrity of the auditory pathway up to the brainstem. MLAEP revealed a differential ear effect, with significant asymmetry in the Na-Pa interamplitude, pointing to a dysfunction in subcortical processing. The P300 showed a prolonged latency in the left ear (437 ms), and there was no response in the right. The FFRs under ideal and impaired listening conditions demonstrated impaired perception of speech and revealed that the neurophysiological responses did not correspond to the eliciting stimulus. Conclusions: The present case study showed that electrophysiological testing of the auditory system provided objective and quantitative evidence for a neurobiological basis of the language deficits of an adolescent with DLD and SLD. The work demonstrated that when comorbidities are present, a multidisciplinary investigation of both the linguistic and auditory systems can be helpful. Full article

Musicians are at an elevated risk for noise-induced hearing loss (NIHL) due to repeated exposure to sound levels exceeding occupational safety guidelines. Although many strides have been made in educating music students on the potential dangers of noise exposure and the mitigating effects of hearing protection devices, the current attitudes on this topic among high school and college-level student musicians remain largely unknown. An electronic survey was administered to high school (n = 195) and university (n = 161)-level band students and ensemble directors (n = 15) regarding knowledge of noise/music-induced hearing loss (MIHL), personal practices with HPDs, and types of education received in band programs regarding hearing health. Results revealed that university-level students reported significantly more awareness and use of HPDs compared to high school students, though neither group reported frequent use overall. Findings also suggested that increased knowledge regarding MIHL significantly predicted hearing protection use among student musicians but also indicated that many student musicians reported only minimal exposure to any type of hearing healthcare curriculum. Ensemble directors overall report occasionally mentioning hearing healthcare to students, but generally do not provide HPDs as part of the program to students. Prior research has suggested that behaviors can be changed with consistent education. A standardized music curriculum that includes proper hearing health practices may help reduce reports of MIHL and increase the use of hearing protection among student musicians. Full article

Background: The reported data on ECG screening are focused on the last two decades. The objectives of this review were bifold: (i) to identify, within a timespan of twenty years, the most recent literature data on cardiac screening in children and adolescents and (ii) to provide data on the procedures used. Methods: Queries were conducted using PubMed, Scopus, and Google Scholar databases for the time window of 2005–2025. The mesh terms used were “ECG”, “Universal Screening”, “Cardiac Pathologies”, “Heart Rate”, and “Sports Pre-participation Evaluation”. Only research articles and review papers were included. The standard English language filter was used. Successively, only research articles were selected. Results: Data from 14 papers were considered, reflecting the lack of information about subjects <16 years of age. Conclusions: The information on objective ECG screening measures is quite scarce, and it is an urgent need to introduce a multidisciplinary approach to differentiate between ECG physiological changes due to growth and ECG pathological changes due to early pathology. Full article

Background/Objectives: Hearing loss constitutes a modifiable risk factor for dementia. Auditory rehabilitation with devices such as cochlear implants (CIs) has been reported to prevent cognitive decline in older adults. However, post-implant cognitive effects remain highly heterogeneous across studies. Thus, the aim of this review is to synthesize the evidence on cognitive outcomes and their interplay with speech perception, quality of life (QoL), and psychological status. Methods: A bibliographic search was conducted following PRISMA guidelines from January 2015 to July 2025. Studies were eligible if they included adult CI candidates who completed cognitive and audiometric assessments. In total, 43 studies, including longitudinal and cross-sectional designs, were reviewed. Several studies also assessed hearing aid (HA) users and normal-hearing (NH) controls. Principal results were identified and analyzed across cognitive domains, audiological performance, QoL, and psychological outcomes. Results: CIs significantly improved cognition across longitudinal studies, with a higher number of assessments reporting gains in memory (61%), global cognition (57%), and executive function (46%); while attention, language, and visuospatial skills were less frequently evaluated. Though findings are not fully consistent, interactions between speech intelligibility and cognitive subdomains have also been found in several studies: global cognition (25%), executive function (22%), visuospatial skills (20%), attention (21%), language (17%), and memory (12%). Improvements in QoL, social engagement, depression, and anxiety are frequently observed. Conclusions: The lack of unified and adapted neurocognitive tools may prevent the observation of consistent outcomes across studies. Further research and multimodal data are still needed to fully understand the interaction between cognition, speech intelligibility, and QoL in CI users. Full article

Objectives: The aim of this study was to evaluate the prevalence of anxiety and depression symptoms and their predictors in 16–19-year-old adolescents with prelingual hearing loss (HL) who use spoken language. Methods: Self- and parent-reported symptoms were measured using RCADS-25 in 250 adolescents with HL (55.2% males; mean age = 17.1 years). A normal hearing (NH) peer group of 69 adolescents (56.5% males; mean age = 16.7 years) completed the self-reported RCADS-25. Key predictor variables included audiological factors, demographic factors, non-verbal IQ, language, communication, prosocial behaviour, and peer relations. Results: The proportion of adolescents with high self-reported anxiety was similar between HL and NH groups (~8%). Depression symptoms were more common in the HL group (11.2% self-reported, 15.8% parent-reported) than in the NH group (7.2%), but the difference was not statistically significant. Across informants, females had worse symptoms, but this association was no longer significant after accounting for communication difficulty. Among hearing aid users, higher prosocial behaviour was associated with fewer depression symptoms, while peer relations were a protective factor in cochlear implant users. Parent- and self-report congruence in symptom rating was modest (r = 0.56–0.68). Predictors of symptoms were consistent across informants, with parent happiness and socio-economic status additionally influencing parent-reported symptoms. Symptoms were unrelated to device type (hearing aid/cochlear implant), degree of hearing loss, or age at intervention. Adolescents with elevated symptoms also reported increased school absenteeism. Conclusions: Adolescents with HL reported anxiety at similar rates to NH peers but may have a higher prevalence of depression. Emotional well-being was influenced primarily by psychosocial and communication factors, not audiological characteristics. Full article

Background: Recreational noise exposure from personal listening devices (PLDs) may lead to hidden hearing loss (HHL), affecting auditory nerve function despite normal pure-tone audiometry (PTA) and otoacoustic emissions (OAE). Subclinical auditory damage at the synaptic level often goes undetected by conventional assessments, emphasizing the need for more sensitive measures. Recorded click ABR in the presence of various levels of ipsilateral maskers for the better identification of auditory damage at the synaptic level. These results could help to develop a better objective diagnostic tool that can detect hidden hearing loss. Objective: To examine the effects of PLD usage on extended high-frequency audiometric thresholds and on click-evoked auditory brainstem responses (ABR) with and without ipsilateral masking in individuals with normal hearing. Materials and Methods: Thirty-five young adults aged 18–35 years (18 PLD users, 17 controls) with clinically normal hearing were recruited. Extended high-frequency audiometry (EHFA) was conducted from 9 to 16 kHz. Click-evoked ABRs were recorded at 80 dB nHL under unmasked and ipsilateral broadband noise-masked conditions at 50, 60, and 70 dB SPL. ABR analyses included absolute and relative amplitude (V/I) and latencies of waves I, III, and V. Results: PLD users demonstrated significantly elevated extended high-frequency thresholds compared to controls. ABR analyses revealed reduced Wave I amplitudes across stimulus conditions in PLD users, while Wave V amplitudes were largely preserved, resulting in consistently higher V/I amplitude ratios under masked conditions. No group differences were observed for Wave III amplitudes or absolute/interpeak latencies, except for a modest prolongation of I–III latency at one masker level in PLD users. Conclusions: Conventional audiological tests may not detect early auditory damage; however, extended high-frequency audiometry and ABR with ipsilateral masking demonstrate greater sensitivity in identifying noise-induced functional changes within the auditory brainstem pathways. Full article

Background: Parent-reported experience in neonatal units is a key but under-measured dimension of family-centred care in Poland. We piloted a brief parent-experience questionnaire informed by the Neonatal Satisfaction Survey (NSS-8) and communication constructs from the Parents’ Experiences of Communication in Neonatal Care (PEC) to describe in-hospital experience and identify actionable targets for improvement. Methods: Observational, cross-sectional pilot at a Polish tertiary centre (September–November 2021). Parents of hospitalized neonates completed a 21-item survey covering educational materials, medical care/communication, parental stress/confidence, hospitalization details, and sociodemographics. Analyses were descriptive with item-wise denominators (n = 32–46). Results: Forty-six parents participated. Educational materials were rated very highly: parental guide 9.8/10 (n = 46); brochure readability 10/10 (n = 46), indicating ceiling effects. Perceptions of care and communication were favourable: overall care 4.47/5, physician concern 4.62/5, ward conditions 4.47/5, explanation of test indications 4.23/5, and adequacy/understandability of information 4.35/5 (each n = 35; medians = 5). Despite this, parental stress/anger/insomnia was moderate (3.00/5; n = 35), while confidence in basic home care remained high (4.10/5; n = 35). Following discharge, 17/46 (37.0%) sought specialist consultations. Length of stay (n = 34) had a median of 1 day (0–4). Reasons for admission most frequently included multisymptom presentations (20/46, 43.5%); respiratory (8.7%) and infectious (6.5%) causes were less common. Conclusions: Parents reported very positive care and communication alongside persistent emotional burden and substantial post-discharge information needs. Findings support pairing a broad experience framework with a focused communication module, standardizing discharge communication (including a 48–72 h “bridging” contact), and progressing to a multicentre psychometric validation. This exploratory pilot was not a formal validation study; mixed scales and item-wise missingness should guide instrument refinement. Full article

Facial expressions and body language play crucial roles in communication by conveying emotional and contextual information. In signed languages, facial expressions also serve linguistic functions. While previous research on autistic individuals’ facial expressions has focused primarily on affective expressions in hearing people, studying deaf autistic individuals offers insight into how autism affects linguistic and affective facial expressions. This case study examines the nonmanual expressions of “Brent,” a Deaf autistic adolescent natively exposed to American Sign Language (ASL). Five video recordings (four monologues and one conversation, totaling 35 m) were coded for nonmanual expressions, including affective facial expressions, question marking, negation, and other functions. Across 590 coded utterances, Brent showed absent or reduced facial expressions for both linguistic and affective purposes. However, he frequently used alternative communicative strategies, including additional manual signs, sign modification, and body enactment. Use of body movement to convey negation, affirmation, or emphasis was observed but inconsistently applied. These findings expand the current understanding of how autistic individuals use facial expressions by including linguistic functions in a signed language and support a broader view of autistic communication that embraces diverse and effective languaging strategies beyond neurotypical norms. Full article