PURPOSE:The study aimed to characterize the multidimensional burden of tinnitus on health-related quality of life (HRQoL) using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) moving beyond symptom severity alone. METHOD:A cross-sectional analysis was conducted using baseline data (N = 428, Mage = 54.9 years, 51.9% female) from several clinical trials examining the efficacy of internet-based cognitive behavioral therapy for tinnitus. Data were collected using a series of online questionnaires including demographic, audiological, and clinical variables. HRQoL was assessed using the EQ-5D-5L profile dimensions. RESULTS:Participants primarily reported no problems with mobility (76.6%), self-care (92.5%), and usual activities (65.2%); however, pain/discomfort (33.4%) and anxiety/depression (40.2%) were the most affected EQ-5D-5L dimensions at baseline. Higher tinnitus severity was consistently associated with worse outcomes across all dimensions (p < .05). A 10-point increase in Tinnitus Functional Index (TFI) scores was associated with 53% and 51% higher odds of worse usual activities and anxiety/depression, respectively. Participants reporting a fully healthy EQ-5D-5L profile had substantially lower tinnitus severity compared with those with any reported problems (mean TFI: 39.0 vs. 55.3, d = 0.78). Cluster analyses identified a smaller subgroup with markedly poorer multidimensional health, characterized by higher tinnitus severity and greater psychological and sleep-related distress, with no significant differences in demographic or audiological characteristics between profiles. CONCLUSIONS:Tinnitus severity is associated with multidimensional reductions in HRQoL, particularly in functional activity and emotional health. The identification of a high-burden profile characterized by anxiety, depression, sleep disturbance, and activity limitation highlights the need for integrated, biopsychosocial approaches to tinnitus management. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.33307416.
PURPOSE:The goal of the present study was to investigate how monaural performance, interaural asymmetry, and the timing of bilateral implantation (simultaneous, sequential) contribute to binaural spectral ripple discrimination and binaural summation in bilateral cochlear implant (BiCI) users. METHOD:Twenty Mandarin-speaking adult BiCI users participated in the study. Of the 20 participants, 10 underwent sequential bilateral cochlear implantation, and 10 underwent simultaneous bilateral cochlear implantation. Spectral resolution was assessed using the Spectral-temporally Modulated Ripple Test (SMRT) under both monaural and binaural listening conditions. Binaural summation benefit was quantified as the difference between binaural SMRT scores and monaural SMRT scores in the better performing ear. Interaural performance asymmetry was quantified as the difference in monaural SMRT scores between each cochlear implant (CI) ear tested individually. Binaural and monaural spectral resolutions were compared in terms of SMRT scores, with binaural summation further examined as a function of interaural performance asymmetry. RESULTS:There was no significant difference in binaural or monaural SMRT scores between the simultaneously implanted BiCI (SIM-BiCI) and sequentially implanted BiCI (SEQ-BiCI) groups. Greater interaural performance asymmetry was strongly associated with reduced binaural summation in the SIM-BiCI group (r = -.91, p < .001) and the SEQ-BiCI group (r = -.89, p < .001). SMRT scores with both CIs were significantly correlated with SMRT scores with the poorer performing CI (r = .70, p < .001). Binaural SMRT scores were significantly predicted by a linear combination of SMRT scores with the poorer ear (p < .001) and the laterality of the poorer ear (right or left ear; p = .022). CONCLUSIONS:While there was no significant difference in binaural summation between SIM-BiCI and SEQ-BiCI users, binaural summation was strongly and negatively associated with interaural performance asymmetry. This suggests that the binaural benefit for spectral resolution is primarily limited by interaural differences in spectral resolution. Binaural SMRT performance was largely dependent on the spectral resolution of the poorer performing CI, with additional improvement associated with better spectral resolution in the right CI.
PURPOSE:The purpose of this study was to clinically and demographically characterize tinnitus in a large sample of patients evaluated in Bogotá, Colombia, and to analyze the factors associated with the level of discomfort. METHOD:A total of 763 medical histories of adults seen between 2018 and 2024 at a specialized tinnitus center were analyzed. Demographic, clinical, and audiological data were collected, in addition to scores from self-report instruments (Tinnitus Handicap Inventory, Tinnitus Reaction Questionnaire, Visual Analog Scale, and percentages of awareness and irritability). A synthetic discomfort index was constructed by utilizing principal component analysis, and subgroup comparisons and correlation analyses were carried out. RESULTS:In the studied sample, the most frequent presentation was nonpulsatile, constant, sudden-onset, bilateral tinnitus, with a median duration of 18 months, primarily affecting sleep and concentration. Besides, both noise exposure and stress were mentioned as triggering factors that increased discomfort. Higher distress levels were observed in women, individuals from cities other than Bogotá, and those reporting a history of migraine or headache, stress, anxiety, or depression; clinically estimated higher noise exposure; or prior tinnitus treatments. Moreover, tinnitus-related discomfort showed a positive correlation with symptom duration and with the number of affected daily-life activities. CONCLUSIONS:These findings contribute to a better understanding of the tinnitus profile in the Colombian population and provide useful evidence to guide intervention strategies. The observed associations underscore the need for comprehensive, individualized management approaches and for continued research on the factors that may influence its progression and treatment.
PURPOSE:The purpose of this study was to evaluate audiologic characteristics of service members (SMs) and veterans who have tinnitus alone or have both tinnitus and posttraumatic stress disorder (T&P), as compared to healthy controls. METHOD:Participants included active duty military SMs and veterans with both T&P (n = 16), tinnitus only (TO; n = 25), and healthy controls (HCs) without posttraumatic stress disorder (PTSD) or tinnitus (n = 20). All participants underwent audiologic evaluation composed of tympanometry, distortion product otoacoustic emissions, pure-tone audiometry, speech audiometry, and loudness discomfort levels. Multivariate analysis of variance was conducted to determine differences in hearing thresholds between the three groups (T&P, TO, and HC). All participants completed the Hyperacusis Questionnaire. Participants with tinnitus (T&P, TO) also received a tinnitus psychoacoustic assessment and completed tinnitus-specific questionnaires. Tinnitus questionnaires included the Tinnitus Functional Index, tinnitus annoyance and loudness rating scales (visual analogue scale), and the Tinnitus Acceptance Questionnaire. Independent-samples t tests were conducted to test for differences between these two groups. RESULTS:Pure-tone and speech audiometry results between the TO and TP groups did not significantly differ. Compared to the TO group, the T&P group reported significantly greater functional impairment due to their tinnitus, perceived their tinnitus as significantly more annoying, and endorsed significantly less acceptance of their tinnitus. Although not statistically significant, participants in the T&P group perceived their tinnitus louder than those in the TO group. CONCLUSIONS:Study findings suggest that PTSD is associated with increased tinnitus distress and annoyance. Symptoms of PTSD may also reduce the capacity to accept tinnitus. These results are consistent with previous studies that demonstrate the additive and negative effects that PTSD may have on health conditions, such as tinnitus. Clinicians within audiology clinics may consider screening specifically for PTSD and make appropriate referrals to behavioral health. Future studies should examine the best sequence of interventions for efficient and effective clinical outcomes among individuals with both conditions.
PURPOSE:The purpose of the study was to identify factors influencing consumer choice toward hearing health care (HHC) delivery pathway (provider-driven vs. over-the-counter [OTC] hearing aids) and to characterize customer archetypes. A secondary purpose was to evaluate shifts in consumer choices and archetypes in light of the recent availability of OTC hearing aids. METHOD:A 27-item survey, adapted from prior work, was administered via Qualtrics Research Panels to over 1,000 U.S. residents aged 50 years and older with no prior hearing aid experience. Multiple linear regressions identified predictive factors for delivery pathway. Principal components analysis and k-means clustering were utilized to develop customer archetypes. RESULTS:Completed surveys obtained from 1,013 respondents showed that while 39% of respondents reported being comfortable with purchasing an OTC hearing aid, 84% preferred a provider-driven model. Insurance coverage and stage of HHC journey were predictive of pathway choice. Three customer archetypes emerged: Empowered Evaluator, Passive Traditionalist, and Disengaged Skeptic. Customer archetypes varied on stage of the HHC journey and comfort managing online transactions. Passive Traditionalists were more likely to pursue provider-driven models of HHC compared to Empowered Evaluators. CONCLUSIONS:Respondents report a strong preference for provider-driven care despite growing comfort with OTC hearing aid options. Insurance coverage, care journey stage, and customer archetypes may influence HHC decisions. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.33071336.
PURPOSE:The aim of this study was to evaluate the accuracy of self-reported hearing asymmetry in predicting objectively defined asymmetric hearing loss (AHL) and identify patient factors associated with over- or underestimation of individual ear hearing loss severity. METHOD:A cross-sectional survey analysis of consecutive adult patients undergoing audiometric evaluation was conducted at the audiology and otology/neurotology clinics of a single tertiary referral center from 2020 to 2025. Fifty patients reporting hearing asymmetry who had not undergone prior audiometric testing within 5 years were included. A survey was administered to quantify subjective individual ear hearing loss severity before audiometric evaluation to determine the accuracy of self-reported AHL (≥ 15 dB interaural difference) and subjective severity estimation for each ear. RESULTS:Seventy percent of patients incorrectly identified AHL based on audiometric testing. Misclassification did not differ significantly according to age, sex, or race. Patients with lower (< 25 dB) or moderate (25-50 dB) binaural pure-tone averages were more likely to misclassify AHL than those with higher thresholds (> 50 dB). Sixty-two percent of patients misclassified the worse hearing ear, with a strong bias toward overestimation (94%). In contrast, 48% misclassified the better hearing ear, with a modest skew toward underestimation (58%). Across subgroups, worse hearing ears were significantly overestimated compared with better hearing ears. Patients with better binaural hearing and narrower interaural differences were more prone to worse hearing ear overestimation. CONCLUSIONS:It is likely that patients do not reliably estimate AHL corresponding to a 15-dB interaural difference. Better binaural hearing and lower interaural asymmetry were associated with poorer estimation of the worse hearing ear, underscoring the importance of audiometric confirmation in patients with preserved hearing.
OBJECTIVE:Environmental sounds are important in our day-to-day auditory experiences. Acoustic properties of sounds help listeners identify and interpret them. Understanding the spectrotemporal features of the environmental sounds is valuable for designing auditory devices and interventions, especially for individuals with hearing impairments. This article aimed to understand the role of spectrotemporal information in the perception of environmental sounds. DESIGN:A literature search was carried out using five electronic databases, including Cochrane Library, Scopus, Web of Science, PubMed, and CINAHL. Key words broadly representing environmental sounds and spectrotemporal features were used. A quality assessment tool for systematic reviews and meta-analyses (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), developed by the National Institutes of Health (Study Quality Assessment Tools), was used for this process. RESULTS:A total of 14 studies that explored the role of either temporal or spectral features or both in environmental sound perception were identified. The combination of spectral measures (such as harmonicity, spectral centroid, spectral velocity, and resolution) and temporal measures (such as duration, envelope, rhythm, and onset time) provides the auditory system with the necessary information to infer the physical properties and actions of sound-producing sources. The most informative frequency range for environmental sound identification was found to be 1200-2400 Hz, comparable to the critical frequency regions of speech. CONCLUSIONS:This scoping review indicates that spectrotemporal features of environmental sounds play a significant role in auditory perception. The review also reveals substantial heterogeneity in study methodologies, thereby making it difficult to generalize. However, the specific features identified in this review may be useful for aural rehabilitation in individuals with hearing disorders.
PURPOSE:This study investigated whether long-term contact lens wear influences vestibulo-ocular reflex (VOR) gain and suppression across a range of stimulus frequencies. Despite frequent use of contact lenses in clinical populations, it remains unclear how optical correction affects VOR assessment outcomes. METHOD:Twelve myopic adults (four men, eight women; 21-25 years) who wore contact lenses at least 12 hr per day, 5 days per week, participated. VOR gain and suppression were measured using sinusoidal harmonic acceleration (SHA) rotary chair testing at 0.04-0.64 Hz, and VOR gain at high frequencies using the video head impulse test (vHIT). Each participant was tested twice: with and without contact lenses. Investigators also noted pupil tracking accuracy. RESULTS:VOR gain increased with frequency, consistent with physiological norms. No significant differences were observed between contact lens and no-contact lens conditions for VOR gain or suppression (SHA and vHIT, right and left canals). Pupil tracking was occasionally more challenging, and variability in VOR gain was higher with contact lenses. CONCLUSIONS:Long-term contact lens wear does not significantly affect VOR gain or suppression. Clinicians may test patients with or without contact lenses; however, caution is advised when lenses are worn due to occasional pupil tracking difficulties and increased response variability.
PURPOSE:The purpose of this study was to assess the level of knowledge, attitudes, and education demands related to hearing aids among the general public in Southwest China. METHODS:This cross-sectional study enrolled 1,239 participants from Southwest China. A self-designed electronic questionnaire was utilized to assess participants' demographics, knowledge, attitudes, and education demand patterns with respect to hearing aids. RESULTS:A total of 48 participants (3.90%) reported that they had "never heard" about hearing aids. A total of 844 participants (68.12%) exhibited a good level of knowledge regarding hearing aids. Factors such as gender, age, education level, profession, self-reported familiarity with hearing aids, monthly income, and willingness to use them significantly influenced the knowledge scores (p < .05). A total of 1,208 participants (97.50%) expressed a willingness to adopt hearing aids. Notably, 1,139 participants (91.90%) preferred to purchase hearing aids from hospitals, with a primary focus on the quality, comfort, and functionality of these devices. Multivariate logistic regression analysis revealed that medical background, higher hearing aid knowledge scores, and a positive inclination toward health education were independent predictors significantly associated with an increased likelihood of hearing aids adoption. A total of 1,051 participants (84.83%) expressed a desire for health education on hearing aids. They preferred to obtain it through "medical staff" (61.02%) or the "Internet" (54.96%). CONCLUSIONS:The general public in this study displayed a basic understanding of and positive attitudes toward the use of hearing aids, and they were eager to obtain professional health education. Therefore, public awareness of hearing aids should be comprehensively improved to better serve patients with hearing loss. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32914130.
IMPORTANCE:Underserved populations, especially Hispanics along the U.S.-Mexico border, are systematically excluded from early hearing loss detection efforts. Without targeted, culturally informed approaches, existing health disparities will only be exacerbated. This study addresses a critical gap in equitable access to hearing health care for Hispanic individuals in the United States. OBJECTIVE:The aim of this study was to examine the outcomes of community-based hearing screenings embedded within a mobile health outreach program in El Paso, Texas, and identify demographic predictors of screening failure. DESIGN, SETTING, AND PARTICIPANTS:This cross-sectional study analyzed data from 305 participants (274 Hispanics) who underwent hearing screenings at six mobile health events. Screenings included otoscopy, pure-tone audiometry, and a brief case history. Logistic regression was used to evaluate the association between demographic variables and hearing screening outcomes. MAIN OUTCOMES AND MEASURES:The primary outcome was hearing screening failure. Demographic predictors included age, gender, ethnicity, primary language, insurance status, and zip code-based income category. RESULTS:Among the 305 participants, 57% failed the hearing screening. A majority (64.4%) reported suspected hearing loss. Older age was significantly associated with screening failure. Compared with privately insured individuals, those with no insurance or public insurance had significantly higher odds of failure. Males were also more likely to fail than females. Primary language and income-based zip code were not significantly associated with screening outcomes. CONCLUSIONS AND RELEVANCE:Embedding hearing screenings within community health outreach initiatives can improve access among underserved populations, though uptake remains low. Age, insurance status, and gender were significant predictors of hearing screening failure among participants, highlighting individual differences that can inform more targeted outreach and intervention strategies in Hispanic communities. To reduce disparities and advance equity in hearing health care access, mobile outreach programs should integrate culturally responsive care, bilingual providers, and robust follow-up systems. These findings support the development of inclusive, community-based models to reach populations historically underserved by traditional health care systems.
OBJECTIVES:Timely access to hearing technology is paramount to ensure early auditory access to the sounds needed for listening and learning in children with early hearing loss (HL). Although children typically move to cochlear implants (CIs) after first having tried hearing aids (HAs), there are some cases where the HA trial may create unnecessary additional delays. This clinical focus article presents three categories of patients where implantation appears warranted without an HA trial. METHOD:This study examines 3 years of retrospective chart data for pediatric CI patients at a tertiary care center who did not complete an HA trial before surgery. RESULTS:We identified 22 cases and examined their diagnostic audiological profiles and preimplant trajectory of care. Our results coalesced around three broad categories where omission of the HA trial appears warranted: cases of late-onset/progressive HL, cases of children lost to follow-up after newborn hearing screening, and cases of auditory neuropathy spectrum disorder where hearing technology was deferred until behavioral testing was possible. Following surgery, we observed wide variability in device use rates, suggesting that some families may struggle with full-time use of CIs despite the streamlined candidacy process. CONCLUSIONS:Taken together, our results show that, in appropriate cases, CIs may be considered for children with HL without first completing an HA trial. This has important implications for closing the timing gaps introduced by loss to follow-up in the United States' national Early Hearing Detection and Intervention program.
PURPOSE:This article describes a new sentence corpus developed for use with children 5 years of age and older that is based on the Basic English Lexicon (BEL) sentence corpus and is referred to as the BabyBEL. METHOD:Sentences were constructed using words found in the expressive vocabulary of native English-speaking kindergarten and first-grade children and organized into 20 lists of 20 sentences each. A female talker recorded all sentences, and speech-shaped masking noise was created based on these recordings. First, psychometric properties of each list as a function of signal-to-noise ratio (SNR) in a cohort of adults were evaluated. Second, speech recognition in noise by list at -2 dB SNR in a cohort of 5- to 7-year-olds was evaluated. Participants had normal hearing and were native speakers of English. RESULTS:Results indicate some differences between lists. The speech recognition threshold associated with 75% correct in adult data varied by no more than ±0.5 dB for 17 of 20 lists. Percent correct scores for children varied by no more than 3 percentage points for 12 of 20 lists. The pattern of performance across lists was similar for adults and children. CONCLUSIONS:The vocabulary and sentence structure of the BabyBEL sentences are appropriate for use with children as young as 5 years of age. Recordings of the BabyBEL corpus are freely available for download. When designing future experiments, it is important to consider performance patterns both across lists and between groups of child and adult listeners. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32715975.
OBJECTIVES:The purpose of this study was to examine the relationship between perceived sound quality and auditory emotion recognition in children with cochlear implants (CIs) and to compare auditory emotion recognition and hearing-related quality of life (HRQoL) between pediatric CI users and age-matched normal-hearing peers. METHOD:Forty-two children aged 7-18 years participated (CI group: n = 21; control group: n = 21). Auditory emotion recognition was assessed using the Montreal Affective Voices (MAV) with 60 nonverbal affective vocalizations representing six emotions (anger, fear, happiness, pain, surprise, and neutral). Perceived sound quality was evaluated with Hearing Implant Sound Quality Index Questionnaire (HISQUI19) and HRQoL with age-appropriate Hearing Environments and Reflection on Quality of Life (HEAR-QL) versions. RESULTS:The CI group demonstrated poorer auditory emotion-recognition performance and lower HRQoL than controls. Correlational analyses in the CI group indicated positive associations between perceived sound quality (HISQUI19) and happiness recognition and between HEAR-QL and both happiness and fear recognition; chronological age was positively associated with neutral emotion recognition, whereas age at implantation was negatively associated with pain recognition. CONCLUSIONS:Pediatric CI users showed poorer nonverbal auditory emotion recognition and lower HRQoL than age-matched normal-hearing peers. Exploratory findings further suggest that perceived sound quality may be selectively associated with happiness recognition in CI users. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32691078.
PURPOSE:Listening workload may partially explain variations in speech recognition that speech audibility alone cannot capture, as increased workload can interfere with speech processing. This study aimed to investigate the association between listening workload and speech recognition in a large sample of the general population with varying ages and hearing thresholds. METHOD:Data from 635 participants, from a longitudinal cohort study, who completed a modified version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) following the Northwestern University Auditory Test No. 6 (NU-6; n = 635), Speech Perception in Noise test (SPIN; n = 440), and Staggered Spondaic Word test (SSW; n = 455) were included. Adjusted for age, sex, and race, linear regressions models were used to examine associations between self-reported workload, defined by NASA-TLX domains of performance, effort, and frustration, with five outcomes of speech recognition, measured by the NU-6 (both adjusted and unadjusted for audibility), SPIN low-context (both adjusted and unadjusted for audibility), and SSW total percent scores. RESULTS:In general, lower levels of self-reported workload were associated with better speech recognition scores, including for audibility-adjusted and non-audibility-adjusted speech recognition tasks and after adjustment for demographic factors. CONCLUSIONS:Findings suggest that self-reported performance, effort, and frustration ratings were associated with speech recognition in various listening conditions, with influences from reduced speech audibility and demographic factors including age, sex, and race. Thus, self-reported workload may serve as a complementary tool to provide better understanding of listening abilities of individuals with hearing loss. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32690985.
PURPOSE:Agricultural mechanics (i.e., "shop") teachers may be at risk for noise-induced hearing loss (NIHL) due to exposure to loud tools and equipment in their classes. To address gaps in previous research, the purpose of this study was to survey Texas shop teachers about their risk of NIHL. METHOD:A nonexperimental survey design was utilized. The online survey was distributed to agriculture teachers in Texas. To participate, respondents had to teach one or more junior high/high school shop classes where loud tools/equipment were used. Questions focused on noise exposure, use of hearing protection, symptoms of hearing loss, and training on hearing conservation. Results from 219 teachers were included in the analyses. RESULTS:Over half the teachers taught three to five courses involving loud tools/equipment each semester. Over two thirds of the teachers reported being exposed to loud noise between 3 and 6 hr a day. For 22/27 tools included in the survey, over 70% of teachers reported exposure. When exposed, between 52% and 93% rarely/never wore hearing protection, depending on the type of tool being used. Over half the teachers reported experiencing different types of hearing problems. In addition, over half of the teachers reported not receiving information on NIHL in college, with only approximately one third receiving such information after college. CONCLUSIONS:The current results suggest that many shop teachers may be at risk for NIHL. Future research should include audiometric evaluations and measurement of noise levels in shop classes, in addition to focusing on areas of need (e.g., training and prevention programs). SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32653461.
PURPOSE:The purpose of this study was to investigate the impact of individuals with different levels of anxiety on postural stability. METHOD:A total of 133 individuals over 18 years old participated: 44 with mild anxiety (Group I), 47 with high anxiety (Group II), and 42 in the control group. None had dizziness complaints. Anxiety levels were determined using the State Anxiety Inventory. Balance was assessed using the Modified Clinical Test of Sensory Interaction on Balance, Limits of Stability (LOS) Test, Walk Across Test, Tandem Walking Test, and Dizziness Handicap Inventory. RESULTS:The study identified significant differences in LOS parameters across anxiety levels. The mild anxiety group demonstrated a reduced right lateral maximum excursion compared to the control group (99.50% ± 5.64% vs. 95.02% ± 8.21%), corresponding to a mean difference of 4.48% (p = .010). Posterior maximum excursion was also significantly lower in both the mild and high anxiety groups relative to controls. The mild anxiety group showed a mean value of 53.97% ± 15.41% versus 64.00% ± 16.05% in controls, yielding a mean difference of 10.03% (p = .006). Similarly, the high anxiety group exhibited a posterior excursion of 53.12% ± 15.82%, with a mean difference of 10.88% from controls (p = .004). These findings indicate that participants with higher anxiety levels demonstrated lower stability limits, particularly in the lateral and posterior directions. CONCLUSION:Anxiety appears to negatively affect maximum excursion values in the LOS Test, suggesting an association between anxiety level and postural control.
PURPOSE:This study aimed to assess postural stability and vestibulo-ocular reflex (VOR) function in patients with chronic suppurative otitis media (CSOM) and to elucidate how vestibular involvement varies according to otoscopic findings and demographic characteristics. METHOD:The study included 51 individuals with CSOM aged 18-65 years (Mage = 34.55 years) and 40 healthy controls (Mage = 33.26 years). All patients had tympanic membrane perforation in at least one ear, for which localization and perforation size were documented. Pure-tone audiometry and immittance measurements were performed. Vestibular assessment consisted of subjective symptom evaluation using the Dizziness Handicap Inventory, semicircular canal-specific VOR gain measurements using the video head impulse test (vHIT), and functional balance analysis using computerized dynamic posturography (CDP). RESULTS:No significant differences were found between groups in vHIT gains for any semicircular canal. While anteroposterior CDP parameters showed no group differences, mediolateral vestibular (VEST), preference (PREF), and Global scores were significantly reduced in the CSOM group. Both disease duration and perforation severity significantly affected mediolateral CDP outcomes, with higher severity and durations longer than 5 years associated with lower VEST, PREF, and Global scores. Somatosensory score, visual score, perforation location, laterality, and anteroposterior sway measures showed no significant differences. CONCLUSIONS:CSOM is associated with subclinical yet measurable impairments in vestibular function and postural stability, characterized by preserved high-frequency semicircular canal function on vHIT but significant mediolateral instability on posturography, even in the absence of self-reported dizziness. These findings indicate early vestibular-mediated balance deficits beyond conductive hearing loss and underscore the importance of routine vestibular assessment for timely identification and targeted rehabilitation.
PURPOSE:Early diagnosis is crucial for infants with hearing loss, but access to specialized services can be challenging for some families. This study piloted a student-facilitated teleaudiology model for infant diagnostics and investigated caregiver opinions of this service in Victoria, Australia. METHOD:Eight families with infants under 6 months old participated in either in-person or teleaudiology appointments, followed by interviews with caregivers to explore their experiences. Thematic analysis was used to analyze interview data. RESULTS:Four main themes emerged: (a) improved accessibility of appointments; (b) effective rapport building and communication, with concerns for supporting challenging scenarios; (c) varying perceptions of facilitator involvement; and (d) level of concern influencing family preferences for appointment type. Caregivers reported positive experiences with teleaudiology, citing improved convenience and reduced travel time as major benefits. However, some expressed concerns about the provision of adequate emotional support in complex cases via telehealth and some impacts of having student facilitators on caregiver confidence in the results. CONCLUSIONS:While a student-facilitated teleaudiology service could improve access to infant diagnostic audiology, family preferences and appointment complexity should be considered when offering this option. Future research should explore the feasibility of this service with a larger sample size. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32144953.
BACKGROUND:Effect sizes quantify the magnitude of group differences, yet hearing aid research still relies on Cohen's benchmarks (0.20, 0.50, 0.80). These cutoffs are not field specific and may misrepresent typical effects. OBJECTIVE:The aims of this study were to characterize the distribution of effect sizes in adult hearing aid research and use these data to estimate sample sizes required to achieve varying levels of statistical power. METHOD:A systematic search of PubMed, CINAHL, and Embase identified English-language randomized controlled trials (RCTs) involving adults with mild-to-severe hearing loss using commercially available air-conduction hearing devices. Eligible outcomes included standardized self-reports and behavioral measures. Absolute Hedges's g values were calculated, with the 25th, 50th, and 75th percentiles representing small, medium, and large effects, respectively. A priori power analyses estimated required sample sizes. RESULTS:From 15,066 records, 33 trials (4,471 participants) met the inclusion criteria; of these, 17 trials provided 63 effect sizes. Across all outcomes, the 25th, 50th, and 75th percentile values (Hedges's g = 0.10, 0.22, and 0.48, respectively) were smaller than Cohen's conventional thresholds (0.20, 0.50, and 0.80, respectively), indicating that Cohen's standardized benchmarks may portray effects in hearing aid research as smaller than they typically are. Estimated sample sizes showed that few published studies met 80% power for a medium effect. CONCLUSIONS:The empirical distribution of effect sizes in hearing aid RCTs is shifted toward smaller numerical values relative to Cohen's conventional benchmarks. Therefore, using Cohen's generic benchmarks makes an effect appear smaller than it is in the context of this field. We recommend using the effect sizes of 0.1, 0.2, and 0.5 for small, medium, and large effect sizes, respectively, when interpreting hearing aid trial results. Adoption of these empirically derived benchmarks will improve the accuracy of interpretation, guide more realistic sample size planning, and enhance the replicability of future trials. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32559894.
PURPOSE:Hearing loss is a common work-related condition. Estimates suggest that 46%-86% of agricultural workers have hearing loss. Agricultural safety programs have been working to increase the use of personal protective equipment (PPE) to protect against noise, respiratory, and chemical exposures, but PPE use remains sporadic. The purpose of this study was to assess factors that might explain the use of hearing protection in agricultural operators working in seven states in the Central United States. METHOD:The Farm and Ranch Health and Safety Survey data collected in 2018, 2020, and 2023 were used for this study. We examined 24 potential correlates of wearing hearing protection. Bivariate analyses were conducted using a Wilcoxon two-sample test based on dichotomizing the frequency of hearing protection use at the median of 10%. We used XGBoost with training and testing data sets to identify the most important factors that explain wearing hearing protection. RESULTS:The strongest predictors of wearing hearing protection was wearing respiratory and chemical PPE, followed by age. Noise exposure was low in importance. The use of hearing, respiratory, and chemical PPE followed a similar pattern over the age spectrum with chemical PPE use showing the most frequent use. Younger operators more frequently wore PPE. CONCLUSIONS:Wearing hearing PPE is more likely to be related to personality traits related to risk perception and less likely due to noise exposures. This is an important consideration when designing hearing loss prevention programs because messaging needs to address safety motivation and unrealistic optimism. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.32513328.
