ACIP Approves 2023 Child/Adolescent and Adult Immunization Schedules

The 2023 child/adolescent and adult immunization schedules have been approved by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and are accessible at https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines.html. These schedules include links to COVID-19 vaccination information, vaccination information statements, adverse event reporting, and a QR code for online schedules. Notable changes include updates to COVID-19 recommendations and mpox (formerly monkeypox) vaccination.

Perceived Listening Difficulties of Adult Cochlear-Implant Users Under Measures Introduced to Combat the Spread of COVID-19.

Following the outbreak of the COVID-19 pandemic, public-health measures introduced to stem the spread of the disease caused profound changes to patterns of daily-life communication. This paper presents the results of an online survey conducted to document adult cochlear-implant (CI) users' perceived listening difficulties under four communication scenarios commonly experienced during the pandemic, specifically when talking: with someone wearing a facemask, under social/physical distancing guidelines, via telephone, and via video call. Results from ninety-four respondents indicated that people considered their in-person listening experiences in some common everyday scenarios to have been significantly worsened by the introduction of mask-wearing and physical distancing. Participants reported experiencing an array of listening difficulties, including reduced speech intelligibility and increased listening effort, which resulted in many people actively avoiding certain communication scenarios at least some of the time. Participants also found listening effortful during remote communication, which became rapidly more prevalent following the outbreak of the pandemic. Potential solutions identified by participants to ease the burden of everyday listening with a CI may have applicability beyond the context of the COVID-19 pandemic. Specifically, the results emphasized the importance of visual cues, including lipreading and live speech-to-text transcriptions, to improve in-person and remote communication for people with a CI.

Cochlear implant habilitation during Covid-19 pandemic: A parents' perspective

Aim and Objectives: The current study was undertaken to assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on cochlear implant rehabilitation of children with congenital nonsyndromic bilateral severe-to-profound sensorineural hearing loss (SNHL). The objectives were to find out the psychological impact of COVID-19 on parents of children with cochlear implant habilitation, to assess the performance of children with cochlear implant habilitation through teletherapy, and to analyze the problems faced by the parents to obtain the professional hearing health-care services for their cochlear implanted children. Materials and Methods: An online questionnaire survey was conducted among the parents of children who had undergone cochlear implantation (CI) consequent to congenital severe-to-profound SNHL. Prior to the COVID-19 pandemic, these children were receiving regular auditory verbal therapy (AVT) including visits to the Centre for audiological services (mapping and troubleshooting of the speech processor). Results: The online questionnaire survey has undertaken. A total of 50 parents were participated in this study. All the parents are unanimously reported that the COVID-19 pandemic has adversely affected them in the form of accessing the professional health-care services for regular mapping and troubleshooting of the speech processor and also their children's rehabilitation. However, active involvement between the health-care professionals and the parents through video consultation and tele AVT has definitely helped the children to a great extent. Conclusion: The present study emphasizes the great challenge posed by the COVID-19 pandemic for continued rehabilitation of CI children. The innovative digital media technology helps in addressing such medical issues through telemedicine, teleaudiology, and teletherapy.

Evaluating Spatial Hearing Using a Dual-Task Approach in a Virtual-Acoustics Environment.

Spatial hearing is critical for communication in everyday sound-rich environments. It is important to gain an understanding of how well users of bilateral hearing devices function in these conditions. The purpose of this work was to evaluate a Virtual Acoustics (VA) version of the Spatial Speech in Noise (SSiN) test, the SSiN-VA. This implementation uses relatively inexpensive equipment and can be performed outside the clinic, allowing for regular monitoring of spatial-hearing performance. The SSiN-VA simultaneously assesses speech discrimination and relative localization with changing source locations in the presence of noise. The use of simultaneous tasks increases the cognitive load to better represent the difficulties faced by listeners in noisy real-world environments. Current clinical assessments may require costly equipment which has a large footprint. Consequently, spatial-hearing assessments may not be conducted at all. Additionally, as patients take greater control of their healthcare outcomes and a greater number of clinical appointments are conducted remotely, outcome measures that allow patients to carry out assessments at home are becoming more relevant. The SSiN-VA was implemented using the 3D Tune-In Toolkit, simulating seven loudspeaker locations spaced at 30° intervals with azimuths between -90° and +90°, and rendered for headphone playback using the binaural spatialization technique. Twelve normal-hearing participants were assessed to evaluate if SSiN-VA produced patterns of responses for relative localization and speech discrimination as a function of azimuth similar to those previously obtained using loudspeaker arrays. Additionally, the effect of the signal-to-noise ratio (SNR), the direction of the shift from target to reference, and the target phonetic contrast on performance were investigated. SSiN-VA led to similar patterns of performance as a function of spatial location compared to loudspeaker setups for both relative localization and speech discrimination. Performance for relative localization was significantly better at the highest SNR than at the lowest SNR tested, and a target shift to the right was associated with an increased likelihood of a correct response. For word discrimination, there was an interaction between SNR and word group. Overall, these outcomes support the use of virtual audio for speech discrimination and relative localization testing in noise.

Measuring Physical Activity in Children With Cochlear Implants Using Self-Reported PAQ-C Before and During the COVID-19 Pandemic

Physical inactivity is common during periods of self-isolation, but for children with special needs, there are crucial benefits to be gained from maintaining moderate to vigorous physical activity throughout the COVID-19 pandemic. This study aimed to compare the physical activity levels of children with cochlear implants and their typically developed peers before and during the COVID-19 pandemic. The sample included 135 children with cochlear implants and 105 typically developed peers. We compared the daily activity levels of the two groups, measured by a 10-item questionnaire and the triangulation method. Results of this study showed that the girls were less active than the boys. Most items had adequate variance, and their means were close to the center of the range of values. The PAQ-C scores for the children with cochlear implants were distributed across a wider range than the scores for the typically developed children. Children with cochlear implants were physically active during school hours but were less active outside school, spending 3 to 6 hours per day using digital media during the COVID-19 pandemic. Children with cochlear implants need to increase their physical activity in and out of school by increasing their level of independence and their ability to adapt to social life. Giving information about physical activity opportunities to parents of children with cochlear implants is an important issue. School presents an opportunity for children to engage in regular physical activity, which is beneficial for their health status.

The impact of face masks on the communication of adults with hearing loss during COVID-19 in a clinical setting.

OBJECTIVE: The aim of the study was to investigate the effect of surgical masks and face shields on speech intelligibility of adults with moderate to severe hearing loss. DESIGN: This study measured speech tracking scores in quiet for life speech in three different conditions: without a mask, with a surgical mask and with a face shield. Acoustic effects of the masks and face shields on the speech signal were also investigated. Study sample: The study sample consists of 42 patients with moderate to severe hearing loss, 23 cochlear implant users and 19 hearing aid users. RESULTS: A significant average difference in speech perception scores was found for the use of a surgical mask compared to the listening situation "without mask". The worse the speech understanding in quiet, the larger the impact of the surgical mask. For the worse performers even the face shield had a negative impact on speech perception. The sound distortion for the face shield compared to the surgical mask was greater. CONCLUSION: This study shows that even for speech perception in quiet, surgical face masks, and face shields to a lesser extent, have a negative effect for patients with moderate to severe hearing loss.

Deafness after COVID-19?

This article presents a case of sudden bilateral deafness in the context of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and resultant coronavirus disease 2019 (COVID-19). After treatment in the intensive care unit for acute respiratory distress syndrome and acute kidney failure, hearing ability had drastically changed. While hearing had been subjectively normal before the infection, deafness was now measured on the left and profound hearing loss on the right ear. The patient was treated with cochlea implants on the left and a hearing aid in the right ear. The hearing loss is most likely a complication of COVID-19.

Impact of face masks in public spaces during COVID-19 pandemic on daily life communication of cochlear implant users.

OBJECTIVE/HYPOTHESIS: Investigate potential problems in the daily life communication of cochlear implant (CI) patients due to the widespread use of face masks in public places during the COVID-19 pandemic. STUDY DESIGN: Prospective survey study. METHODS: This study used an online questionnaire about the effects of face masks on daily life communication of adult CI users. The questionnaire consists of three parts: (a) A face mask questionnaire, (b) loneliness question (c) three subdomains of the Nijmegen Cochlear Implant Questionnaire to assess quality of life. The questionnaires were send out on October 20, 2020. Four hundred and seven adult CI users were invited to participate in the study. The survey inclusion was closed on November 5, 2020. The study setting was the Rotterdam Cochlear Implant Center, Erasmus MC, a tertiary referral center in The Netherlands. The loneliness question and Nijmegen Cochlear Implant Questionnaire were analyzed for possible differences between the current situation with masks and the situation before, when masks were not commonly used. RESULTS: Two hundred and twenty one adult CI users (54% female, mean age 62 years) participated in the study. The face mask questionnaire showed that face masks cause considerable problems in daily life communication of 80% of the participants. Also, CI users tend to feel more lonely and all used subdomains of the Nijmegen Cochlear Implant Questionnaire worsened due to the use of face masks. CONCLUSION: The widespread use of face masks greatly complicates the daily life communication of CI users and reduces quality of life. LEVEL OF EVIDENCE: 3.

Pediatric Hearing Loss Management in the COVID-19 Era: Possible Consequences and Resources for the Next Future.

Pediatric hearing loss early diagnosis and treatment have been limited by the current restrictions due to the coronavirus disease 2019 pandemic. The difficulty in accessing the multiple facilities required for the rehabilitative process is influencing the timing of each step of the process. Auditory hearing screening programs, etiological characterization, surgical timing, and speech therapies have all been limited in the past year. The current conditions have forced us to adopt different strategies to overcome the necessary social distancing prescriptions. Although their efficacy should be proved over time, some of these resources will be probably useful even in a nonpandemic future.

[Deafness after COVID-19? German version]. / Ertaubung nach COVID-19?

This article presents a case of sudden bilateral deafness in the context of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and resultant coronavirus disease 2019 (COVID-19). After treatment in the intensive care unit for acute respiratory distress syndrome and acute kidney failure, hearing ability had drastically changed. While hearing had been subjectively normal before the infection, deafness was now measured on the left and profound hearing loss on the right ear. The patient was treated with cochlea implants on the left and a hearing aid in the right ear. The hearing loss is most likely a complication of COVID-19.

A prospective study on the feasibility of cochlear implantation during the coronavirus disease 2019 crisis and trends of assessment: experience in a UK centre.

OBJECTIVES: To demonstrate the feasibility of continuing cochlear implantation during the coronavirus disease 2019 crisis and to report on trends of referrals via the neonatal hearing screening programme. METHODS: A prospective case series was conducted on children who underwent cochlear implantation during the coronavirus disease 2019 crisis in the UK and a sample of referrals via the neonatal hearing screening programme. A step-by-step description of peri-operative management is included. RESULTS: Regionally, between February and May 2020, 106 babies were referred via the neonatal hearing screening programme to paediatric audiology. Eleven children were operated on during the coronavirus disease 2019 study period. None of the 11 children developed coronavirus symptoms. DISCUSSION: It is widely recognised that the demands of managing the current pandemic may compromise screening, clinical assessment and elective surgery. Time-sensitive issues such as cancer management have gained prominence, but a similar need exists for timely paediatric cochlear implantation. CONCLUSION: Implantation in the paediatric population during the coronavirus disease 2019 pandemic is feasible with careful planning.

A Review of Contemporary Teleaudiology: Literature Review, Technology, and Considerations for Practicing.

The scope of teleaudiology has been noted with telehealth due to Coronavirus disease (COVID-19) recently. As the notion has been around us for more than 20 years ever since 1999, it is necessary to perceive the knowledge accurately and prepare for the successful implementation of it. Therefore, the literature review including screening and diagnostic audiometry, cochlear implants and hearing aids, and aural rehabilitation, telecommunications technology regarding several fields of teleaudiology, and considerations for practicing were identified. Although overall internet-based audiological services showed benefits in terms of outcome and accessibility, uncertainties of cost-effectiveness, the optimal level of support, and a need for further studies of many aspects for teleaudiology has arisen. In the view of technology, the store-and-forward (asynchronous/hybrid) and a real-time (synchronous) methods were introduced with one applied and nine registered patents recorded from 2004 to 2020 for the invention of teleaudiology in the United States. Also, 10 checklists were suggested for planning teleaudiology practice from prior experience in hosting the teleaudiology program. Conclusively, it is hoped that this review sheds light on recognizing and improving the existing teleaudiology services and helps overcome the challenges faced in the era of pandemic and untact world to come.

A novel treatment for CI extrusion with vacuum-assisted closure device.

OBJECTIVE: To assess if a vacuum-assisted closure device initially utilised as a temporising measure to dress a wound defect over a cochlear implant prior to definitive surgical intervention could instead be used to close the soft tissue and avoid surgery. METHOD: This is a case report describing the novel use of VAC (Vacuum-Assisted Closure Device) in the successful closure of a wound defect with cochlear implant hardware exposure post soft tissue infection during the Covid-19 pandemic. RESULTS: While the VAC system was initiated for temporary wound coverage, it was observed at each dressing change to be successfully decreasing the soft tissue defect for our patient. This resulted in complete epithelisation of the soft tissue defect at Day 35 and avoidance of a surgical procedure. The patient was able to restart wearing her device on Day 50 and Cochlear MAPping performed on Day 58 showed minimal changes in patient's current requirements compared to her settings pre-infection. CONCLUSION: The use of V.A.C dressing for a small soft tissue defect over an extruded cochlear implant seems promising as exemplified by our case study. However, due to the lack of literature, more studies should be done to prove its usefulness in such an application.

Impact of COVID-19 on the access to hearing health care services for children with cochlear implants: a survey of parents.

Background: The COVID-19 pandemic has affected the world in an unprecedented manner. It has aggravated psychological distress in parents of children with cochlear implants. Continuous use of a speech sound processor is critical for auditory stimulation in children with cochlear implants. However, movement restrictions imposed have affected access to hearing healthcare services. The current study explores the impact of the COVID-19 pandemic on hearing healthcare access for children with cochlear implants. Methods: An online questionnaire survey was conducted among parents of children with cochlear implants. Results: A total of 24 parents responded to the questionnaire. All the respondents reported that COVID-19 has a significant impact on access to hearing health services for their children. Speech processor breakdown and disconnection from the auditory mode of communication had a critical influence on behavioral changes in children. Conclusions: The current study highlights the hurdles faced by the parents in order to access hearing health services for their children. The use of innovative methods such as remote tele-audiology will be the way forward to tackle challenges faced by the parents.