Audiology Research最新文献

{"title":"Exploring Embryonic and Postnatal Gene Therapy Approaches for GJB2-Related Deafness: A Scoping Review.","authors":"Valeria Caragli, Alessandro Martini","doi":"10.3390/audiolres16020049","DOIUrl":"10.3390/audiolres16020049","url":null,"abstract":"<p><p><i>Purpose:</i> Hearing loss (HL) is a prevalent condition significantly impairing quality of life, with genetic mutations accounting for a substantial proportion of congenital cases, notably those involving the GJB2 gene encoding connexin 26. This study aims to analyze the current knowledge, feasibility, and challenges of gene therapy targeting GJB2-related HL, emphasizing both embryonic and postnatal interventions. <i>Methods:</i> A comprehensive scoping review was conducted across electronic databases up to October 2025, including studies focusing on GJB2-associated HL, gene therapy approaches, and the timing of interventions. Data extraction encompassed mutation types, animal models, delivery strategies, outcomes, and ethical considerations. <i>Results:</i> The results indicated over 467 GJB2 variants which could impair cochlear ion homeostasis and development. Animal models, mainly murine, demonstrated early-onset degeneration with limited recovery following delayed gene therapy, while early postnatal intervention showed greater efficacy. Viral vectors like AAV have been employed for targeted gene delivery via cochlear injections, achieving partial restoration of connexin expression and cochlear function, yet they have faced limitations including transduction efficiency, immune responses, and long-term stability. Challenges in translating these findings to humans have been compounded by anatomical, immunological, ethical, and safety issues, particularly regarding embryonic gene therapy and germline modifications. Ethical frameworks can vary internationally, highlighting the necessity for careful regulation. <i>Conclusions:</i> While promising advances in gene therapy for GJB2-related HL have been achieved in preclinical studies, significant scientific, technical, and ethical barriers must be addressed before clinical application, especially during embryogenesis. A multidisciplinary, cautious approach is essential to realize the potential of gene therapy in restoring natural hearing while safeguarding individual and societal interests.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of a Natural Dietary Supplement for Tinnitus: An Observational Prospective Exploratory Study.","authors":"Massiel Cepeda Uceta, Estela Lladó-Carbó, Raidili Mateo Montero, Catalina Villa Jurado, Montserrat Virumbrales, Iván Domènech Juan","doi":"10.3390/audiolres16020048","DOIUrl":"10.3390/audiolres16020048","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The objective of the study was to assess the benefits on quality of life (QoL) of a natural-based dietary supplement in patients with tinnitus. <b>Methods</b>: An observational, prospective and exploratory study was conducted in 30 patients (mean age 50.7 years) diagnosed with tinnitus. The dietary supplement (Otocalm^®) contained L-theanine, <i>Gingko biloba</i>, melatonin, GABA, zinc, selenium and vitamins B3, B6 and B12, and was administered for 90 consecutive days. Clinical assessment included tone verbal audiometry, the Tinnitus Handicap Inventory (THI), the Goldberg anxiety and depression scale (GADS), and a 0-10 mm visual analogue scale (VAS) to score the intensity of tinnitus. <b>Results</b>: The mean THI score decreased from 40.8 at baseline to 30.9 at the end of the study (<i>p</i> = 0.012), and the percentage of patients with THI grade 1 (no handicap) increased from 3.3% to 20%. The mean anxiety score decreased from 4.7 to 3.0 (<i>p</i> = 0.006), and the percentage of patients scoring ≥ 4 in the GADS decreased from 63.3% to 33.3%. Changes in VAS scores and verbal tone audiometry were not observed. A decrease in the mean frequency of tinnitus from 2417.4 Hz to 1603.3 Hz (<i>p</i> = 0.519) was found. The product was safe and well-tolerated. <b>Conclusions</b>: The administration of a natural-based dietary supplement composed of L-theanine, <i>Ginkgo biloba</i>, melatonin, GABA, zinc, selenium, and group B vitamins during 90 days in patients with tinnitus was associated with a significant increase in QoL by reducing tinnitus-associated handicap and anxiety.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical Reconstruction of the Ear and Temporal Region: Structural and Functional Considerations Including Hearing Rehabilitation-A Narrative Review.","authors":"Florin-Vlad Hodea, Eliza-Maria Bordeanu-Diaconescu, Andrei Cretu, Vladut-Alin Ratoiu, Cristian-Sorin Hariga, Cristian-Radu Jecan, Ioan Lascar, Andreea Grosu-Bularda","doi":"10.3390/audiolres16020047","DOIUrl":"10.3390/audiolres16020047","url":null,"abstract":"<p><p>Reconstruction of the ear and temporal region presents unique challenges due to the complex anatomy of the lateral skull base and the need to restore both structural integrity and auditory function. Historically managed as separate entities, auricular reconstruction and hearing rehabilitation are increasingly approached in an integrated manner, supported by advances in microsurgical techniques and implantable hearing technologies. This narrative review synthesizes contemporary evidence on microsurgical reconstruction of the ear and temporal region in conjunction with hearing rehabilitation, analyzing a wide range of existing surgical techniques in an integrative manner. Reconstructive techniques discussed include local and regional flaps, free tissue transfer, auricular framework reconstruction using autologous cartilage or alloplastic materials, external auditory canal reconstruction, and subtotal petrosectomy. Hearing rehabilitation options reviewed encompass bone-anchored hearing systems, active and passive transcutaneous devices, middle ear implants, and cochlear implantation. Simultaneous reconstruction and implantation may reduce surgical burden and enable earlier hearing restoration in carefully selected patients, while staged approaches remain advantageous in complex or high-risk scenarios, particularly in the presence of chronic infection or extensive temporal bone surgery. Multidisciplinary collaboration, meticulous preoperative planning, and long-term follow-up are essential to optimize outcomes.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Wearable System for Postural Balance Assessment: Comparison with EquiTest and Static Posturography in Healthy Adults.","authors":"Valerio Maria Di Pasquale Fiasca, Alfredo Gabriele Nanni, Marco Pozzi, Lorenzo Collino, Barbara Martino, Paolo Ranieri, Eliana Filipponi, Giulio Dehesh, Andrea Beghi, Federica Di Berardino","doi":"10.3390/audiolres16020045","DOIUrl":"10.3390/audiolres16020045","url":null,"abstract":"<p><p><b>Background</b>: Objective assessment of postural control is central to the clinical evaluation of vestibular disorders. Although force-platform-based posturography is considered the gold standard, its use may be limited by cost and infrastructural requirements. Wearable inertial measurement units (IMUs) represent a promising alternative; however, their clinical validation should account for intrinsic differences in measurement paradigms rather than strict metric equivalence. <b>Objective</b>: To preliminarily evaluate the within-session reliability of a wearable IMU-based medical device for balance assessment (Gravity), and its agreement with established static (SBP) and computerised dynamic posturographic systems (CDP) in healthy subjects. <b>Methods</b>: Sixty-three healthy adults were enrolled in two independent method comparison studies: a wearable IMU-based balance system versus a static stabilometric platform (GRAVITY vs. SVEP; <i>n</i> = 42) and a wearable IMU-based balance system versus computerised dynamic posturography (Gravity vs. EquiTest; <i>n</i> = 21). Gravity measurements were obtained simultaneously with reference systems across standardised sensory conditions. Within-session reliability and method agreement were assessed. <b>Results</b>: Within-session reliability of Gravity was outcome-dependent. Length-based components demonstrated higher repeatability (ICC (single) = 0.25-0.35; ICC (average) = 0.41-0.52), with narrower limits of agreement (LoA = ±9-12%) and lower measurement error (SEM = 3.3-4.3%). In comparison with SBP, length-based measures exhibited narrower limits (LoA = ±12-17) and more consistent relationships. Comparison with CDP revealed moderate agreement for composite and preferential scores (LoA: -2.20-7.07; -5.54-8.12). <b>Conclusions</b>: Gravity sensor may represent a clinically meaningful, outcome-dependent performance, with superior reliability and comparability for length-based postural measures compared with area-based measures. The device could provide balance assessments compatible with both static and dynamic posturographic systems, accounting for physiological variability. These findings support the potential clinical use of wearable IMU-based posturography, particularly in settings where conventional force-platform systems are not readily available, and warrant further validation in larger, more clinically diverse populations.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Air-Bone Gap: The Role of Bone Conduction Thresholds in Predicting Functional Outcomes and Guiding Surgical Decision-Making in Active Middle Ear and Bone Conduction Implants.","authors":"Joan Lorente-Piera, Raquel Manrique-Huarte, Sebastián Picciafuoco, Janaina P Lima, Valeria Serra, Manuel Manrique","doi":"10.3390/audiolres16020046","DOIUrl":"10.3390/audiolres16020046","url":null,"abstract":"<p><p><b>Introduction</b>: In patients with conductive and mixed hearing loss, implantable hearing devices such as active middle ear implants (AMEIs) and bone conduction implants (BCIs) are established alternatives when conventional hearing aids fail. Although bone conduction (BC) thresholds are routinely used as eligibility criteria, their role as frequency-specific predictors of postoperative functional outcomes remains poorly defined. This study aimed to evaluate the influence of preoperative BC thresholds across the audiometric spectrum on postoperative speech recognition outcomes after implantation with AMEIs and BCIs. <b>Methods</b>: A retrospective observational study was conducted at a tertiary referral center including patients implanted with BCIs or AMEIs. Pre- and postoperative audiological data were analyzed, including air and bone conduction thresholds, frequency-segmented BC measures (low, mid, and high frequencies), cochlear frequency gradient (ΔBC Slope), and speech recognition scores (SRSs) at 65 dB HL one year after implantation. <b>Results</b>: 102 patients were included (50 BCI, 52 AMEI). Both implant types achieved significant postoperative improvements in tonal thresholds and SRS compared with pre-implantation values (all <i>p</i> < 0.001). High-frequency BC thresholds (BC-High, 4-6 kHz) showed a significant inverse correlation with postoperative SRS in both BCI (r = -0.382, <i>p</i> = 0.001) and AMEI users (r = -0.398, <i>p</i> < 0.001), and emerged as the only independent predictor in multivariable models (BCI: β = -0.533, <i>p</i> = 0.022; AMEI: β = -0.491, <i>p</i> = 0.020). Low- and mid-frequency BC measures were not associated with postoperative speech outcomes (all <i>p</i> > 0.05). ROC analyses demonstrated excellent discriminative performance of BC-High for identifying suboptimal outcomes, with area under the curve values of 0.92 for BCI (<i>p</i> = 0.001) and 0.94 for AMEI (<i>p</i> = 0.002), and implant-specific cutoff values of >47 dB HL and >61 dB HL, respectively. <b>Conclusions</b>: High-frequency BC thresholds showed the strongest association with postoperative speech recognition after implantable hearing rehabilitation. BC-High could function as a prognostic marker of functional outcome rather than an eligibility criterion, providing clinically meaningful information to refine preoperative counseling and individualized decision-making within current indication frameworks.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating the Sensation-Emotion-Cognition (SEC) Model into Tinnitus Care: A Preliminary Exploratory Study of a Comprehensive Tinnitus Management Protocol.","authors":"María Del Carmen Moleón González, Farzon Danesh, Ali A Danesh","doi":"10.3390/audiolres16020043","DOIUrl":"10.3390/audiolres16020043","url":null,"abstract":"<p><strong>Background: </strong>Tinnitus, the perception of sound in the absence of an external source, is a prevalent condition that can substantially affect physical and mental health. Although tinnitus is not typically curable, it is often manageable with structured, multidisciplinary care. This pilot research describes the Sensation-Emotion-Cognition (SEC) model, a practical audiological framework developed by Danesh et al. that targets three core dimensions of the tinnitus experience.</p><p><strong>Methods: </strong>We integrate findings from an exploratory retrospective cohort and a prospective expansion study. The SEC protocol included sound therapy, counseling and relaxation training, and cognitive behavioral therapy (CBT) delivered through either unguided, module-based internet CBT, clinician-guided module-based internet CBT, or six therapist-led CBT sessions. The objective was to evaluate whether this multifactorial approach is associated with reductions in tinnitus-related distress.</p><p><strong>Results: </strong>In this prospective study, preliminary results from 16 participants who completed the study were associated with significant pre-post changes in tinnitus-related outcomes: 4C management confidence increased from M = 30.38 to 60.19 (<i>p</i> < 0.001; Cohen's dz = 1.04), and SAD-T emotional distress decreased from M = 4.75 to 2.38 (<i>p</i> = 0.001; Cohen's dz = 0.99).</p><p><strong>Conclusions: </strong>These findings suggest the potential value of an integrated management strategy; however, given the single-group pre-post design and attrition, the results should be interpreted as exploratory and warrant confirmation in larger controlled trials.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear Implantation in Down Syndrome: Functional Outcomes, Challenges, and Management Strategies.","authors":"David H Elisha, David H Cohen, Andrea Monterrubio, Ryan Hossain, Nicholas DiStefano, Rahul Mittal, Adrien A Eshraghi","doi":"10.3390/audiolres16020044","DOIUrl":"10.3390/audiolres16020044","url":null,"abstract":"<p><p><b>Objective:</b> The aim was to evaluate cochlear implantation (CI) outcomes in children with Down syndrome (DS) with severe-to-profound sensorineural hearing loss (SNHL), addressing a literature gap and discussing challenges including anatomical abnormalities, cognitive deficits, and Eustachian tube dysfunction. <b>Data Sources:</b> Systematic searches were conducted in PubMed, Web of Science, Scopus, and Embase from inception through to June 2025. <b>Review Methods:</b> A systematic review adhering to PRISMA guidelines was performed. Included studies reported CI outcomes in DS patients receiving otolaryngologic care for SNHL. Extracted data included findings on ear anatomy, auditory performance, speech/language development, intelligibility, and duration of CI use. <b>Results:</b> A total of 149 abstracts were screened, yielding six studies with 26 patients that met the inclusion criteria. The review included pediatric DS patients with documented ages at implantation spanning from 11 months to 17.9 years. CI provided significant benefits for DS patients, including improved audiometric results, enhanced environmental awareness, and psychosocial gains. Optimal outcomes were associated with early implantation, thorough preoperative imaging (CT/MRI), and management of middle ear disease. Variability in outcomes often reflected cognitive limitations and anatomical challenges such as cochlear nerve hypoplasia and Eustachian tube dysfunction. <b>Conclusions:</b> CI can significantly improve quality of life and communication in children with DS when tailored to their unique needs. Preoperative imaging is essential to assess candidacy, and middle ear disease should be addressed prior to surgery. Clinicians should counsel families with individualized goals that emphasize functional hearing gains over normative speech benchmarks. Broader adoption of CI in this population may be supported by standardized, population-sensitive outcome measures and future prospective studies.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Nanotechnology-Based Application on Balance Control in Hearing Aid Users.","authors":"Francesca Campoli, Andrea Fabris, Donatella Di Corrado, Dorota Kostrzewa-Nowak, Robert Nowak, Lucio Caprioli, Vincenzo Cristian Francavilla, Elvira Padua, Giuseppe Messina","doi":"10.3390/audiolres16020042","DOIUrl":"10.3390/audiolres16020042","url":null,"abstract":"<p><strong>Background: </strong>Balance impairment and falls are a major health concern in older adults. Beyond vestibular and visual factors, growing evidence indicates that age-related hearing loss contributes to postural instability through altered multisensory integration. However, interventions addressing the interaction between auditory input and postural control remain limited. This study examined whether integrating Taopatch^® nanotechnology, based on localized photobiomodulation, into conventional hearing aids could influence postural control in individuals with hearing loss.</p><p><strong>Methods: </strong>Forty experienced hearing aid users (mean age 77.3 ± 15.6 years) completed five postural assessments using a SensorMedica^® baropodometric platform. Four sessions employed a placebo patch identical in appearance to the active device, and the fifth used Taopatch^®. Static and stabilometric parameters were analyzed under open- and closed-eye conditions.</p><p><strong>Results: </strong>Significant improvements were observed with the Taopatch^®-integrated device. Sway path length (-8%, <i>p</i> = 0.002), mean velocity (-8%, <i>p</i> = 0.002), and low-frequency sway (-30%, <i>p</i> = 0.04) decreased, indicating smoother and more efficient postural control. A lateral redistribution of plantar load and an increase in contact surface area (up to +15%) were also found. These effects were less evident without visual input.</p><p><strong>Conclusions: </strong>Preliminary findings suggest that localized photobiomodulation integrated into hearing aids may positively influence postural stability in older adults with hearing impairment, possibly by supporting sensory integration processes. Further controlled studies are needed to confirm these effects and clarify the underlying mechanisms.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Water Method for Reducing Air Conduction in Soft Tissue Conduction.","authors":"Shai Chordekar, Haim Sohmer, Miriam Geal-Dor","doi":"10.3390/audiolres16020041","DOIUrl":"10.3390/audiolres16020041","url":null,"abstract":"<p><p><b>Background:</b> Bone vibrator (BV) stimulation applied to skin sites on the body elicits hearing by soft tissue conduction (STC). However, BV stimulation to sites far from the ear requires the delivery of higher-intensity stimulus vibrations to achieve threshold, which can then induce hearing by air conduction (AC) contamination. This problem limits the study of STC thresholds at sites more distant from the ear. <b>Objective:</b> To overcome this problem, we evaluated the possibility of delivering STC vibratory stimuli to body sites in a water bath, based on the different acoustic impedances between air and water, which produces a 30 dB reduction in transmission from water to air. <b>Methods:</b> A standard clinical BV delivered vibration stimuli (tonal and speech stimuli) applied directly to two body sites: finger and foot. BV and body sites were immersed in a water bath. One control involved both stimulation site and BV both in water, but not in contact. In an additional control, the BV was in the bath, while the stimulation site was out of the bath. <b>Results:</b> STC hearing of both pure tones and speech could be elicited at stimulus intensities below those induced by control stimulation (body site and BV both in water, but not in contact; BV in bath, stimulation site out of bath). STC thresholds at the finger site were lower than those at the foot. <b>Conclusions:</b> The current results suggest that water-immersion method enables study of STC hearing in response to higher-intensity vibrational stimuli, and at body sites more distant from the ear, without contamination by AC hearing.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside Approach to Acute Vertigo with Spontaneous Horizontal Nystagmus: The Role of Simultaneous Ice-Water Test Stimulation and Its Correlation with the HINTS Protocol in Differentiating Peripheral and Central Etiologies.","authors":"Luigi Califano, Cataldo Latorre, Maria Grazia Melillo, Iacopo Cangiano, Giuseppe Manna, Maria Gabriella Coppola, Roberto Teggi","doi":"10.3390/audiolres16020039","DOIUrl":"10.3390/audiolres16020039","url":null,"abstract":"<p><strong>Background: </strong>Acute vertigo is among the most frequent causes of access to the Emergency Department. In acute vestibular syndrome, differentiating peripheral from central causes remains challenging. The HINTS protocol provides high diagnostic accuracy but requires expertise and adequately informed physicians. The caloric ice-water test has recently been proposed as a bedside tool to aid this differential diagnosis. This study evaluates a novel approach: simultaneous bilateral ice-water irrigation in association with the HINTS protocol.</p><p><strong>Methods: </strong>One hundred consecutive patients presenting with acute vertigo and spontaneous unidirectional nystagmus were enrolled across three Italian centers. All patients underwent clinical assessment including among other the HINTS protocol and the simultaneous bilateral ice-water irrigation. Changes in spontaneous nystagmus during the ice test were recorded.</p><p><strong>Results: </strong>Eighty-six patients fulfilled HINTS criteria for acute unilateral peripheral vestibulopathy, all of whom demonstrated marked suppression/abolition of nystagmus during the simultaneous ice test. In contrast, nystagmus persisted in all 12 patients classified as having central vestibular pathology.</p><p><strong>Conclusions: </strong>Simultaneous bilateral ice-water irrigation is a simple and well-tolerated bedside test that demonstrates strong concordance with the HINTS protocol. While it cannot replace comprehensive clinical assessment, it represents a valuable complementary tool to distinguish peripheral from central causes of acute vertigo.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}