Multifrequency Analysis of Masseter Vestibular Evoked Myogenic Potentials in Young Adults.

PURPOSE: The purpose of this study was to explore the dynamics of multifrequency tone bursts on the masseter vestibular evoked myogenic potential (mVEMP) parameters. Furthermore, it sought to determine the optimal frequency tuning of mVEMP responses. METHOD: Twenty young adults with normal hearing sensitivity participated in the study. Bilateral tone burst evoked mVEMPs were obtained using the zygomatic montage at 250-, 500-, 750-, 1000-, 1500-, and 2000-Hz stimulation frequencies. Self-monitoring biofeedback was given during the procedure to confirm the tension of the masseter muscle between 49.9 and 150.6 rms. Furthermore, the electromyography (EMG) scaling was done to avoid any muscle-related irregularities. RESULTS: Tone burst evoked mVEMPs were found to be 100% present at the stimulation frequencies of 250, 500, 750, and 1000 Hz. There were no ear and gender effects seen for any of the frequencies. Significant shortening of the P1 and N1 latencies with increasing stimulation frequencies was observed. The peak-to-peak amplitude was the highest at 500 Hz and lowest at 2000 Hz tone bursts under both EMG scaled and unscaled conditions. CONCLUSION: The present revealed higher response rates and larger amplitudes study of mVEMP at lower frequencies, and, therefore, the frequency tuning was seen for the stimulation frequency at 500 Hz.

Exploring the Relationship Between Masseter and Cervical Vestibular Evoked Myogenic Potentials in Young Adults with Normal Hearing.

BACKGROUND: Cervical vestibular evoked myogenic potentials (cVEMPs) and masseter vestibular evoked myogenic potentials (mVEMPs) are considered to have a common saccular origin. While a few studies have examined both VEMPs in individuals with brainstem disorders as part of a test battery, the relation between these two potentials has rarely been the subject of discussion. PURPOSE: The present study explored the relation between mVEMPs and cVEMPs using EMG-scaled parameters in normal-hearing young adults. RESEARCH DESIGN: Within-subject study design Study Sample: Twenty young adults between 18 to 39 years of age (11 males, 9 females) participated in the study. DATA COLLECTION AND ANALYSIS: cVEMP and mVEMP were performed on all the participants at 95dBnHL with 500Hz tone burst stimuli. Various VEMP parameters were evaluated including P13 and N23 peak latencies, the amplitude of the P13-N23 complex, and the Interaural Amplitude Asymmetry Ratio (IAAR) in EMG-scaled and unscaled conditions. RESULTS: All participants exhibited a 100% response rate for cVEMP and mVEMP responses. There were no significant ears and gender effect for both cVEMP and mVEMP. No correlation was found between cVEMP and mVEMP. There was no significant difference found between P1 and N1 latency values of cVEMP and mVEMP; however, a significant variation was observed for peak to peak amplitude both in EMG scaled and unscaled conditions between cVEMP and mVEMP. CONCLUSIONS: Minimal to no association between any parameters of cVEMPs and mVEMPs suggests no significant relationship between these two VEMPs.

Comparison of Chirp Versus Tone Burst- and Click-Evoked Masseteric Vestibular Evoked Myogenic Potentials in Normal-Hearing Adults.

PURPOSE: This study aimed at comparing narrowband Claus Elberling level-specific chirp (NB CE-Chirp)-, click-, and tone burst-evoked masseteric vestibular evoked myogenic potentials (mVEMPs). METHOD: Within-group study design and purposive sampling were performed. A total of 25 normal-hearing individuals participated in the study. The zygomatic electrode montage was used to elicit ipsilateral mVEMP responses using a 500-Hz NB CE-Chirp, a click of 100-µs duration, and a 500-Hz tone burst stimulus. Each of the responses was analyzed based on the absolute peak latency of P11 and N21, the electromyography-scaled peak-to-peak amplitude of the P11-N21 complex, and the interaural asymmetry ratio. RESULTS: A total of 50 ears were tested and had 100% mVEMP responses. The latencies of click-evoked and 500-Hz NB CE-Chirp-evoked mVEMPs were significantly shorter than those of 500-Hz tone burst-evoked mVEMPs (p < .05) for both ears. It revealed a significantly superior P11-N21 amplitude of the 500-Hz NB CE-Chirp and tone burst than clicks for both ears. Intraclass correlation coefficient revealed moderate to excellent test-retest reliability for mVEMP parameters across three different stimulations. CONCLUSION: The present study supports 500 Hz NB CE-Chirps as effective and reliable stimuli as tone bursts in eliciting mVEMP responses.

Comparison of Multifrequency Narrow Band CE-Chirp and Tone Burst Evoked Cervical Vestibular Evoked Myogenic Potentials.

BACKGROUND: Cervical Vestibular Evoked Myogenic Potentials (cVEMPs) are inhibitory myogenic responses that have commonly been elicited using a variety of stimuli. Yet, the comparison of the effects of multi-frequency tone bursts and narrowband Claus Elberling chirps (NB CE-chirps) on cVEMPs has never been studied in homogeneous age groups. PURPOSE: The present study focused on comparing the effect of multi-frequency NB CE-chirps and tone bursts on the various parameters of cVEMP responses in normal-hearing younger adults. RESEARCH DESIGN: A within-group study design was applied, and purposive sampling was utilized for the collection of the data sample. STUDY SAMPLE: The present study involved the elicitation of NB CE-chirps and tone bursts evoked cVEMPs across four-octave frequencies in 25 normal-hearing younger adults. RESULTS: NB CE-chirps and tone bursts evoked cVEMPs were found to have a 100% response rate for all frequencies except 4000 Hz. Across frequencies, P1 and N1 latencies were seen to be significantly shorter for NB CE-chirps than tone bursts at 500 Hz and 1000 Hz stimulation. No differences were seen in the P1N1 amplitudes and inter-aural asymmetry ratio (IAAR) between the two stimuli across all four-octave frequencies. Further, it was found to have a significantly higher number of ears tuned to NB CE-chirps than tone bursts at 500 Hz. CONCLUSIONS: Comparative differences in the latencies of cVEMP responses between and within stimuli could be due to the variation in stimuli duration. Also, the difference in amplitudes across stimulation frequencies might have resulted due to the predominance of saccular responses at lower mechanical resonance frequencies. Thus, the tuning was also seen at 500 Hz and was relatively higher for NB CE-chirps than tone bursts.

Impact of COVID-19 Pandemic on Older Adults Using Hearing aid/s: Indian Scenario.

The present study explored the impact of COVID-19 on hearing health and problems faced by older adults using hearing aid/s. Fifty older adults in the age range of 55-95 years were selected for the study based on the inclusion and exclusion criteria. Therefore, the developed questionnaire was administered to them. Statistical analysis was performed for all the responses achieved. Closure of hearing aid companies and audiological centers was found to have a negative impact on availing audiological services. Likewise, a huge hike in the price of these services made it impossible for people to afford them. Despite the availability of tele-audiology, older adults were not able to make the best use of it due to numerous reasons. We sought to explore patients' perceptions to break down these barriers by enhancing the quality of tele-audiology, home visits, and remote services. Therefore, the present report may facilitate in planning and implementation of policies related to audiological services, especially during times of crisis, which may help strengthen our hearing health care system. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03209-8.

Multifrequency Narrowband Chirp Evoked Cervical Vestibular Myogenic Potentials: Evaluation of Responses in Normal-Hearing Young Adults.

PURPOSE: The study aimed to explore the various parameters of multifrequency narrowband Claus Elberling chirp (NB CE-chirp) evoked cervical vestibular evoked myogenic potentials (cVEMPs) in normal-hearing healthy young adults. The study also attempted to define the optimal frequency tuning characteristic of NB CE-chirp evoked cVEMPs. METHOD: cVEMP was performed on 26 young healthy adults using four different NB CE-chirps centered at 500, 1000, 2000, and 4000 Hz. The neck torsion method was applied for electrode placement. To have the acute recording, visual feedback of sternocleidomastoid muscle contraction was provided, and electromyography (EMG) scaling was done. RESULTS: cVEMPs were present for 100% across all frequencies except at 4000 Hz. Amplitudes between each pair of frequencies were significantly different for EMG scaled and unscaled conditions. Frequency tuning was observed at 500 Hz regardless of scaling done. Positive peak 1 of cVEMP (P1) latencies showed no differences between frequencies while both negative peak 1 of cVEMP and the complex of positive peak 1 and negative peak 1 of cVEMP (P1N1) interpeak latency values decreased with increasing frequency. Interaural amplitude asymmetry ratio showed no difference between scaled and unscaled amplitudes. Intraclass correlation revealed a range of test-retest reliability across frequencies. EMG unscaled amplitude were having relatively lower test-retest reliability consistently across frequencies Conclusions: Differences in amplitudes between frequencies with a maximum at 500 Hz can be attributed to the low frequency centered saccular response. No differences in P1 were observed. Yet, N1 latency and P1N1 interpeak latency difference gradually shortened with the decrement in the stimulus duration as the stimulation frequency increased. The lower reliability of EMG unscaled amplitude across frequencies supports the need to use EMG scaling to avoid confounding variables related to muscle contraction.

Importance of Vestibulo-ocular Reflex Gain and Refixation Saccade Analysis in Individuals with Auditory Neuropathy Spectrum Disorder

Abstract Introduction Auditory neuropathy spectrum disorder (ANSD) features the presence of otoacoustic emissions, poor speech identification score and absent auditory brainstem response. Objective The present study was designed to evaluate the functioning of all six semicircular canals in individuals with ANSD and to compare it with those of normalhearing individuals. Methods A total of 50 individuals participated in the present study, in which Group I comprised25normal-hearingindividuals, and GroupII comprised25individualswithANSD. All of the participants underwent case history, pure tone audiometry, immittance, otoacoustic emissions, auditory evoked response and video head impulse test (vHIT). Results The independent sample t-test revealed significantly lower vestibulo-ocular reflex gain values in individuals with ANSD. A presence of 100% corrective refixation saccades was observed in the same group. The Pearson correlation test revealed no significant correlation between vestibulo-ocular reflex (VOR) gain with duration of hearing loss and pure tone thresholds for any of the three orthogonal planes. The chisquared test revealed no association between the VOR gain values and the presence or absence of saccades in any of the semicircular canals (p>0.05). Conclusion Huge percentages of individuals with ANSD have been found to have associated vestibular dysfunction as well. Therefore, the vHIT can be used as one of the important tests of the vestibular test battery to evaluate all six semicircular canals in individuals with ANSD.

Importance of Vestibulo-ocular Reflex Gain and Refixation Saccade Analysis in Individuals with Auditory Neuropathy Spectrum Disorder.

Introduction Auditory neuropathy spectrum disorder (ANSD) features the presence of otoacoustic emissions, poor speech identification score and absent auditory brainstem response. Objective The present study was designed to evaluate the functioning of all six semicircular canals in individuals with ANSD and to compare it with those of normal-hearing individuals. Methods A total of 50 individuals participated in the present study, in which Group I comprised 25 normal-hearing individuals, and Group II comprised 25 individuals with ANSD. All of the participants underwent case history, pure tone audiometry, immittance, otoacoustic emissions, auditory evoked response and video head impulse test (vHIT). Results The independent sample t-test revealed significantly lower vestibulo-ocular reflex gain values in individuals with ANSD. A presence of 100% corrective refixation saccades was observed in the same group. The Pearson correlation test revealed no significant correlation between vestibulo-ocular reflex (VOR) gain with duration of hearing loss and pure tone thresholds for any of the three orthogonal planes. The chi-squared test revealed no association between the VOR gain values and the presence or absence of saccades in any of the semicircular canals ( p > 0.05). Conclusion Huge percentages of individuals with ANSD have been found to have associated vestibular dysfunction as well. Therefore, the vHIT can be used as one of the important tests of the vestibular test battery to evaluate all six semicircular canals in individuals with ANSD.

Expectations and Experience of Children with Unilateral Cochlear Implantation: A Parental Perspective.

To find out parental expectations regarding outcomes of unilateral cochlear implantation prior to surgery and experience received by them after cochlear implantation and 1 year of regular auditory verbal therapy, with respect to the communication abilities, social skills and participation. Total of 200 parents of hearing impaired children participated in the study. A closed ended questionnaire containing 13 questions were used to collect the data. The participants were instructed to complete all the questions provided based on their expectations and experiences. The descriptive statistics were used to determine the frequency and percentage. Among 200 parents, almost all (95%) of the parents expected to have improvement in all the subscale of communication abilities, social skills and participation. 68.5% of the parents experienced improvement in their child's communication abilities, such as, response to quiet sounds, repetition of words without seeing speaker's face, elimination of use of gestures, easy communication and verbal expression for needs, thoughts and feelings. 76% of the parents experienced improvement in social skills and participations, such as, good relationship with elders, siblings and peers, making friends outside the family, actively participating in the activity done by other children and easily accepted by peers in the classroom. A large number of parents met with their expectations and a small proportion of families were found to be disappointed due to high hopes and unrealistic expectation before implantation, which had adverse effect on the children's performance.

Development and standardization of tinnitus handicap inventory in Nepali.

BACKGROUND: Tinnitus is a frequent but sparsely understood condition of human ear featuring unusual sensation of acoustic energy. A symptom specific inventory forassessment of tinnitus may aid in understanding the severity of the problem and its impact on individuals' life. Initially, English version of THI was the only existing assessment tool available in measuring the impact of tinnitus. Being a self-report inventory, it is vital that the individuals with tinnitus understand the language foradministering instrument. Therefore, the present study aimed at developing and validating self-administering Tinnitus Handicap Inventory (THI) in Nepali language. METHODS: Standard method of translation-back-translation was utilized where English version of THI was translated and customized by four professors with degree in Nepalilanguage. Later it was administered on 20 native literate Nepali speakers whose first language was Nepali for content validity. Therefore it was administered on 120 patients and total scores under different subscales were measured. RESULTS: Out of 120 individuals, 20% of them had severe, 20% had moderate, 26% of them had mild and 34% of them had slight tinnitus handicap scores. Nepali version of THI was found to have an alpha value of 0.92. Across three subscales (emotional,functional and catastrophic), Nepali version of THI got the alpha scores of 0.91, 0.91 and 0.80 and Item-total correlation of 0.26-0.74, 0.057-0.90 and 0.54-0.90 respectively. CONCLUSIONS: Present study confirmed that the THI-Nepali version has good internal consistency and reliability as compare to the original English version and otherestablished versions. Therefore, THI-Nepali version can be used as a robust, easy to use, reliable and valid tool in self-assessment of tinnitus handicap in Nepali speaking individuals with tinnitus in clinical as well as research setting. However, test-retest reliability of the developed questionnaire is essential.

Psychometric Features of Dizziness Handicap Inventory (DHI): Development and Standardization in Gujarati Language.

OBJECTIVE: Dizziness is a sensation of spatial disorientation of rotating or non-rotating in nature, mostly due to Oto-neurological insults. A symptom-specific dizziness handicap inventory may aid in understanding the severity of the condition and its impact on the quality of life. Therefore, the Dizziness Handicap Inventory-English version (DHI-E) was used as the most reliable subjective tool to assess the effect of dizziness in various aspects of life and so was translated into several languages. Hence, the present study aimed at developing and standardizing the self-administering Dizziness Handicap Inventory - Gujarati version (DHI-G). METHODS: A cross-sectional survey design was performed. 50 participants, i.e. 18 males and 32 females aged between 15 to 55 years with complaints of vertigo/dizziness were recruited for the study. The questionnaire was re-administered to thirty of the total participants after 10 days of initial administration for examining test-retest reliability. RESULTS: DHI-G achieved an overall alpha score of 0.92 suggesting good internal consistency and the score of 0.84, 0.82 and 0.81 on three subscales i.e. physical, functional and emotional respectively. Intra class correlation (ICC) revealed good test-retest reliability with a score of 0.81. CONCLUSION: DHI-G can be used as a reliable and valid tool in the clinical and research setting extensively.

Higher Asymmetry Ratio and Refixation Saccades in Individuals with Motion Sickness.

BACKGROUND: Motion sickness is a complex autonomic phenomenon caused by the intersensory conflict among the balancing systems, resulting in a mismatch of signals between static physical conditions of the susceptible individual exposed to dynamic environment. PURPOSE: The present study was done to assess the sacculocollic reflex pathway and six semicircular canals in individuals susceptible to motion sickness. RESEARCH DESIGN: Standard group comparison was used. STUDY SAMPLE: A total of 60 participants with an age range of 17-25 yr were included, where group I comprised 30 participants with motion sickness and group II comprised 30 participants without motion sickness. The Motion Sickness Susceptibility Questionnaire-Short was administered to classify the participants into groups with or without motion sickness. DATA COLLECTION AND ANALYSIS: The cervical vestibular-evoked myogenic potential (cVEMP) test and video head impulse test (vHIT) were administered to all participants. The Shapiro-Wilk test revealed normal distribution of the data (p > 0.05). Hence a parametric independent sample t test was done to check significant difference in cVEMP and vHIT parameters between the two groups. RESULTS: The present study revealed no significant difference for cVEMP latencies and amplitude in individuals with motion sickness. However, significantly higher cVEMP asymmetry ratio was observed in individuals with motion sickness. Though the vestibulo-ocular reflex (VOR) gain values showed no significant difference between the two groups except for the right anterior left posterior plane, the asymmetry in VOR gain values revealed significant difference between the groups, suggesting asymmetry as a better parameter than absolute VOR gain values. Also, the presence of refixation saccades in 100% of the individuals with motion sickness accorded with various studies reported earlier with vestibular-related pathologies. CONCLUSIONS: Presence of higher asymmetry ratio in cVEMP and vHIT test results plus refixation saccades to stabilize the gaze in vHIT can suggest some amount of vestibular anomalies in individuals with motion sickness.