Assessment of Peripheral and Central Auditory Processing after Treatment for Idiopathic Sudden Sensorineural Hearing Loss.

Introduction When cases of idiopathic sudden sensorineural hearing loss (SSNHL) are treated successfully, most clinicians assume the normality and symmetry of the auditory processing. This assumption is based on the recovery of the detection ability on the part of the patients, but the auditory processing involves much more than detection alone. Since certain studies have suggested a possible involvement of the central auditory system during the acute phase of sudden hearing loss, the present study hypothesized that auditory processing would be asymmetric in people who have experienced sudden hearing loss. Objective To assess the physiologic and electrophysiological conditions of the cochlea and central auditory system, as well as behavioral discrimination, of three primary aspects of sound (intensity, frequency, and time) in subjects with normal ears and ears treated successfully for SSNHL. Methods The study included 19 SSNHL patients whose normal and treated ears were assessed for otoacoustic emissions, speech auditory brainstem response, intensity and pitch discrimination, and temporal resolution in a within-subject design. Results The otoacoustic emissions were poorer in the treated ears compared to the normal ears. Ear- and sex-dependent differences were observed regarding otoacoustic emissions and pitch discrimination. Conclusion The asymmetrical processing observed in the present study was not consistent with the hearing threshold values, which might suggest that the central auditory system would be affected regardless of the status of the peripheral hearing. Further experiments with larger samples, different recovery scenarios after treatment, and other assessments are required.

Audio-Vestibular Profile of COVID-19; Systematic Review and Meta-analysis.

Introduction: After more than a year of the COVID-19 pandemic, audio-vestibular problems have been reported as consequences. Several limited case report studies with different methodologies were published. This study aimed to describe the impact of COVID-19 on the auditory-vestibular system and communication problems in subjects with hearing impairment. Materials and Methods: The current systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. PubMed, Web of Science, and Google Scholar were searched to find relevant articles using combined keywords. Results: Out of 26 final studies, 20 studies dealt with the effects of COVID-19 on the auditory and vestibular system, and six articles examined the COVID-19 effects on hearing-impaired people and patients. In these studies, dizziness (17.8%), tinnitus (8.1%), and vertigo (2.8%) were common symptoms. Most studies were case reports (42.30%), and in terms of quality, nine studies (34.61%) were in the suitable quality group. Conclusions: COVID-19 might cause auditory-vestibular system problems by directly affecting the structures or functions of the inner ear or by weakening the immune system. The need for taking preventive measures during the COVID-19 pandemic has caused communication and social challenges, particularly for people with hearing loss.

Comparing Sound-Field Speech-Auditory Brainstem Response Components between Cochlear Implant Users with Different Speech Recognition in Noise Scores.

Objectives: Many studies have suggested that cochlear implant (CI) users vary in terms of speech recognition in noise. Studies in this field attribute this variety partly to subcortical auditory processing. Studying speech-Auditory Brainstem Response (speech-ABR) provides good information about speech processing; thus, this work was designed to compare speech-ABR components between two groups of CI users with good and poor speech recognition in noise scores. Materials & Methods: The present study was conducted on two groups of CI users aged 8-10 years old. The first group (CI-good) consisted of 15 children with prelingual CI who had good speech recognition in noise performance. The second group (CI-poor) was matched with the first group, but they had poor speech recognition in noise performance. The speech-ABR test in a sound-field presentation was performed for all the participants. Results: The speech-ABR response showed more delay in C, D, E, F, O latencies in CI-poor than CI-good users (P <0.05), meanwhile no significant difference was observed in initial wave (V(t= -0.293, p= 0.771 and A (t= -1.051, p= 0.307). Analysis in spectral-domain showed a weaker representation of fundamental frequency as well as the first formant and high-frequency component of speech stimuli in the CI users with poor auditory performance. Conclusions: Results revealed that CI users who showed poor auditory performance in noise performance had deficits in encoding the periodic portion of speech signals at the brainstem level. Also, this study could be as physiological evidence for poorer pitch processing in CI users with poor speech recognition in noise performance.

The Prevalence of Voice Disorders and the Related Factors in University Professors: A Systematic Review and Meta-Analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to estimate the prevalence of voice disorders and related factors in university professors. METHODS: In this systematic review, Medline, Scopus, Embase, Cochrane Library, Eric, ProQuest, Magiran, Scientific Information Database and IranDoc databases were searched. The search was limited to January 1990 and May 2020. The inclusion criteria were reports of the prevalence of voice disorders in university professors and original studies in English and Persian languages. The exclusion criteria were studies assessing voice disorders in school or music teachers; the full-text not available; and case studies, conference papers, and review studies. All eligible studies were selected and critically appraised using the Joanna Briggs Institute checklist. Finally, a meta-analysis was performed using STATA 16.0 statistical software. RESULTS: The preliminary search yielded 1251 articles and 18 of which met the eligibility criteria. The overall prevalence of voice disorders in university professors was 41% (Pooled prevalence: 0.41, 95% CI: 0.34-0.49, P-value < 0.001). Country-based analysis showed that the highest prevalence of voice disorders among university professors was in Iran 69% (Pooled prevalence: 0.69, 95% CI: 0.62-0.76) and the lowest was in China 20% (Pooled prevalence: 0.20, CI: 0.14-0.27). Among 4037 university professors, caffeine consumption was the most frequent related factor (87%) and dry throat was the most frequent symptom (46%). CONCLUSIONS: The present study yielded about 41% of the professors had voice disorders. Among the influential habits, caffeine consumption and among the symptoms, dry throat were very common in university professors. Due to the cross-sectional nature of our studies, we were not able to perform further analyses on the risk factors for voice disorders. Therefore, more longitudinal surveys are needed for reaching a more reliable and deep view into the development of voice disorders.

Vestibular Evoked Myogenic Potentials in Cervical Myofascial Pain Syndrome.

Cervical myofascial pain syndrome with dizziness (CMPS-D) has always faced the challenges of evaluation, diagnosis, and etiology. Vestibular-evoked myogenic potentials (VEMPs) are applicable to evaluate the functions of the vestibular system, especially the saccule. The Sound evoked triceps myogenic potentials (SETMPs) have different anatomical efferent connections from Sternocleidomastoid (SCM)-VEMPs. The present study aimed to evaluate the SETMPs and SCMVEMPs in CMPS-D group and compare the results with the control group. We tested 15 participants with CMPS-D with 15 participants in the control group using SCMVEMP and SETMP tests. All participants had normal hearing and vestibular functions. The SCMVEMP response was absent in 4 of 15 patients with CMPS-D, and the mean response CMPS-D group was significantly lower than the control group. There were the SETMP and SCMVEMP responses in all participants in the control group. In CMPS-D subjects with false absent SCMVEMP response, SETMP tests are suitable alternatives for the saccule evaluation, and diminished SCMVEMP in the CMPS-D subjects may not necessarily mean the saccular injury. Furthermore, the involvement of spinal cord pathways is not a cause of dizziness in CMPS-D patients.

The Efficacy of the Half Somersault Maneuver in Comparison to the Epley Maneuver in Patients with Benign Paroxysmal Positional Vertigo.

OBJECTIVE: Benign Paroxysmal Positional Vertigo (BPPV) as the most common vestibular disorder can affect the quality of life. This study aimed to compare the effectiveness of the half somersault maneuver (HSM) as a treatment to that of the Epley maneuver (EM) as a clinical-based treatment in subjects with PC-BPPV. METHODS: In this randomized study, 43 participants with unilateral posterior canal BPPV were recruited. The experimental group received the HSM, whereas the control group received the EM. All participants were asked to fill in the Vestibular Rehabilitation Benefit Questionnaire (VRBQ), Dizziness Handicap Inventory (DHI), and Vertigo Symptom Scale (VSS) questionnaires at pretreatment and at 48 hours, 1 week, and 1 month posttreatment. The severity of residual dizziness was determined by the visual analog scale (VAS) weekly for up to 4 weeks after treatment. The success rate and the recurrence rate were assessed after the 3-month follow-up. RESULTS: The differences between the results of pretreatment and post-treatment questionnaires for both groups were significant. However, the differences were not significant between the 2 groups for the DHI scores, the total, dizziness, motion-provoked dizziness, and symptom subscale scores of the VRBQ, and the anxiety subscale scores of the VSS. There were significant differences between the 2 groups for VAS, the total VSS and vertigo subscale scores, and the VRBQ anxiety subscale scores. CONCLUSION: Even though both maneuvers are significantly effective in the treatment of PC-BPPV, subjects in the HSM group reported more improvement in terms of psychometric symptoms and residual dizziness compared to the EM group.

Thyroid-Stimulating Hormone and Free Thyroxine Alterations in Subjects with Occupational Hearing Loss.

CONTEXT AND AIM: Occupational hearing loss (OHL) is caused by exposure to industrial noise. Alterations in the thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels are related to hearing loss. The purpose of this study is to investigate the TSH and FT4 level alterations in OHL. METHODS AND MATERIAL: Among 428 subjects, 144 male workers with normal hearing (NH), noise-induced hearing loss (NIHL), and high tone loss (HTL) (N = 48 in each group) were included in this study. All the subjects had normal TSH and FT4 levels. RESULTS: The TSH level is higher in the HTL and NIHL groups in comparison to NH, but it is only significant in the HTL group. The FT4 level is significantly lower in the NIHL group; however, the lower FT4 level in the HTL group is not significant when compared to the NH group. DISCUSSION: The NIHL group may turn into the HTL group over time. This process could be monitored by alteration in their TSH and FT4 levels. CONCLUSIONS: Alterations in the TSH and FT4 levels could be considered as a pathophysiology for OHL. More research is required to investigate the electrophysiological, physiological, and histological correlations of TSH and FT4 and different types of hearing loss caused by noise exposure.

The Additional Effect of Vestibular Rehabilitation Therapy on Residual Dizziness After Successful Modified Epley Procedure for Posterior Canal Benign Paroxysmal Positional Vertigo.

Purpose The aim of the study was to evaluate the additional effect of vestibular rehabilitation therapy (VRT) compared with the modified Epley procedure alone on residual dizziness after a successful modified Epley procedure in patients with posterior canal benign paroxysmal positional vertigo (BPPV). Method In this cross-sectional analytical comparative study, 47 patients (35 women and 12 men) aged 18-80 years with posterior canal BPPV were randomly assigned to one of two following groups: the control group, who received the modified Epley procedure only, and the VRT group, who received the modified Epley procedure plus vestibular rehabilitation for 4 weeks. Outcome measures, including the Dizziness Handicap Inventory (DHI), the Vertigo Symptom Scale-Long Version (VSS-L), and the Vertigo Symptom Scale-Short Form (VSS-SF), were conducted on the same session before initial therapy (T1), at 48 hr later (T2), and at 4 weeks later (T3). Presence or absence of residual dizziness was evaluated at T2. Results Residual dizziness was found in 20 (42.6%) patients after a successful modified Epley procedure. There was no statistically significant difference between the mean DHI, VSS-L, and VSS-SF scores at T1, T2, and T3 in patients who manifested with residual dizziness and those without residual dizziness in both groups. The average DHI, VSS-L, and VSS-SF score reduced during the time in both groups. These results were demonstrated that the VRT group and the control group have similar reductions in symptoms after treatment with the VRT plus modified Epley procedure and the modified Epley procedure only, respectively. Conclusions Residual dizziness is a common condition after a successful modified Epley procedure for BPPV. The VRT plus modified Epley procedure is as effective as modified Epley procedure alone in the management of residual dizziness. Further studies with supervised and customized VRT and longer follow-up periods are needed. Supplemental Material https://doi.org/10.23641/asha.14825508.

Sound-Field Speech Evoked Auditory Brainstem Response in Cochlear-Implant Recipients.

BACKGROUND AND OBJECTIVES: Currently limited information is available on speech stimuli processing at the subcortical level in the recipients of cochlear implant (CI). Speech processing in the brainstem level is measured using speech-auditory brainstem response (S-ABR). The purpose of the present study was to measure the S-ABR components in the sound-field presentation in CI recipients, and compare with normal hearing (NH) children. Subjects and. METHODS: In this descriptive-analytical study, participants were divided in two groups: patients with CIs; and NH group. The CI group consisted of 20 prelingual hearing impairment children (mean age=8.90 ± 0.79 years), with ipsilateral CIs (right side). The control group consisted of 20 healthy NH children, with comparable age and sex distribution. The S-ABR was evoked by the 40-ms synthesized /da/ syllable stimulus that was indicated in the sound-field presentation. RESULTS: Sound-field S-ABR measured in the CI recipients indicated statistically significant delayed latencies, than in the NH group. In addition, these results demonstrated that the frequency following response peak amplitude was significantly higher in CI recipients, than in the NH counterparts (p<0.05). Finally, the neural phase locking were significantly lower in CI recipients (p<0.05). CONCLUSIONS: The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech process in CI recipients.

Pitch matching in bimodal cochlear implant patients: Effects of frequency, spectral envelope, and level.

This study systematically investigated the effects of frequency, level, and spectral envelope on pitch matching in twelve bimodal cochlear implant (CI) users. The participants were asked to vary the frequency and level of a pure or complex tone (adjustable sounds) presented in the non-implanted ear to match the pitch and loudness of different reference stimuli presented to the implanted ear. Three reference sounds were used: single electrode pulse trains, pure tones, and piano notes. The data showed a significant effect of the frequency and complexity of the reference sounds. No significant effect of the level of the reference sounds was found. The magnitude of effect of frequency was compressed in the implanted ear: on average a difference of seven semitones in the non-implanted ear induced the same pitch change as a difference of 19 to 24 semitones for a stimulus presented to the implanted ear. The spectral envelope of the adjustable sound presented to the non-implanted ear also had a significant effect. The matched frequencies were higher by an average of six semitones for the pure tone compared to a complex tone. Overall, the CI listeners might have matched the stimuli based on timbre characteristics such as brightness.

A cochlear implant user with exceptional musical hearing ability.

UNLABELLED: Although the perception of music is generally poor in cochlear implant users, there are a few excellent performers. OBJECTIVE: The aim of this study was the assessment of different aspects of music perception in one exceptional cochlear implant user. DESIGN: The assessments included pitch direction discrimination, melody and timbre recognition, relative and absolute pitch judgment, and consonance rating of musical notes presented through the sound processor(s). STUDY SAMPLE: An adult cochlear implant user with musical background who lost her hearing postlingually, and five normally-hearing listeners with musical training participated in the study. RESULTS: The CI user discriminated pitch direction for sounds differing by one semitone and recognized melody with nearly 100% accuracy. Her results in timbre recognition were better than average published data for cochlear implant users. Her consonance rating, and relative and absolute pitch perception were comparable to normally-hearing listeners with musical training. CONCLUSION: The results in this study showed that excellent performance is possible on musical perception tasks including pitch perception using present day cochlear implant technologies. Factors that may explain this user's exceptional performance are short duration of deafness, pre- and post-deafness musical training, and perfect pitch abilities before the onset of deafness.