Audiology Research最新文献

{"title":"Automatic Detection of Extracochlear Electrodes in Cochlear Implants Using Electric Field Imaging: Bench and Clinical Validation.","authors":"Mehrangiz Ashiri, Tony Spahr, Chen Chen, Azret Botash, Ashish Mehta, Patrick Boyle, Manohar Bance, Daniele Borsetto, Susan T Eitutis, Jordan J Varghese, Craig A Buchman, René H Gifford, Andrea J DeFreese, Matthew Miller, Syed F Ahsan, Christopher Danner, Kyle P Allen, Loren Bartels, Kanthaiah Koka","doi":"10.3390/audiolres16040119","DOIUrl":"10.3390/audiolres16040119","url":null,"abstract":"<p><strong>Objectives: </strong>Extracochlear electrodes (EEs), defined as electrode contacts located outside the cochlea, can degrade cochlear implant (CI) performance. We present and validate an Electric Field Imaging (EFI)-based algorithm that helps detect EEs and can be used intra- or post-operatively.</p><p><strong>Methods: </strong>An algorithm for detecting EEs from EFI data was developed. Validation and testing were performed using three datasets: (a) bench models with known EE conditions (saline and resistive load model), (b) clinical EFI recordings from CI recipients with imaging confirmation (CT or plain X-ray), and (c) EFI recordings without imaging. Primary outcomes included the ability to differentiate extracochlear conditions from fully inserted electrode arrays, as well as the concordance between the number of EE contacts identified by the algorithm and those determined from controlled bench configurations or available imaging data.</p><p><strong>Results: </strong>The algorithm reliably differentiated full insertion from EE conditions on bench models and clinical EFI recordings from CI recipients with imaging confirmation. In the imaging-confirmed clinical cohort (6 EE cases among 226 CI recipients), the algorithm achieved 100% sensitivity and specificity. In clinical cases without imaging, the algorithm flagged 3.94% as having extracochlear electrodes, within the range of prevalence reported in the literature. Furthermore, the lateral-wall electrode arrays were associated with a significantly higher extracochlear electrode occurrence compared to the pre-curved arrays.</p><p><strong>Conclusions: </strong>This EFI-based algorithm may provide a useful screening tool for EEs using routine clinical measurements, supporting intra-operative and post-operative detection while reducing reliance on imaging and thereby aiding clinical decision-making. The method can be integrated into existing clinical fitting software workflow and complements recent work on EFI-based tip fold-over detection. The observed sensitivity and specificity suggest that this approach may provide a valuable tool for identifying EEs in situations where imaging is unavailable or impractical.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833280","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":"Dexmedetomidine and Chloral Hydrate Sedation on ABR Indices in Children.","authors":"Lan Wang, Qiong Li, Bin Zhang, Shaohan Wang, Shanshan Tian, Yu Han, Wenbin Wang, Zhaomin Fan, Haibo Wang, Yu Ai","doi":"10.3390/audiolres16040118","DOIUrl":"10.3390/audiolres16040118","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The study was aiming to determine the test-retest repeatability of DEX or CH as single sedative agents on ABR indices by analyzing data from initial test and retest. We also preliminarily explored the correlation between sleep deprivation and onset time of sedation in group DEX and group CH, respectively. <b>Methods</b>: We collected data from two groups of children sedated with either DEX (<i>n</i> = 20, 40 ears) or CH (<i>n</i> = 20, 40 ears). Paired- samples <i>t</i>-tests and Bland-Altman plots were used to evaluate repeatability between the initial test and retest. Pearson correlation analysis was used to measure the relationship between the average onset time of sedation and the average duration of sleep deprivation in both groups. <b>Results</b>: Within each sedative group, no significant differences were observed in ABR indices between the initial test and retest. Additionally, in group DEX, the mean onset time was 12.15 ± 4.40 min and the mean sleep deprivation duration was 442.80 ± 85.91 min, with no correlation between them (r = 0.01, <i>p</i> = 0.96). In group CH, the mean onset time was 27.55 ± 15.70 min and the mean sleep deprivation duration was 455.10 ± 90.94 min, showing a significant negative correlation (r = -0.97, <i>p</i> = 0.00). <b>Conclusions</b>: ABR indices exhibited high repeatability when DEX and CH were used as a sedative in pediatric ABR examinations. The choice of sedative agent in clinical practice should be individualized, taking into account institutional protocols and clinical requirements.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833323","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":"Pathophysiological Variants of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Toward an Integrative Model Based on Otoconial Location and Cupular Dynamics.","authors":"Joan Lorente-Piera, Raquel Manrique-Huarte, Nicolás Pérez-Fernández","doi":"10.3390/audiolres16040117","DOIUrl":"10.3390/audiolres16040117","url":null,"abstract":"<p><p><b>Objective:</b> To critically synthesize the available evidence on the pathophysiological variants of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) and to propose an integrative model based on otoconial location and cupular dynamics to explain their clinical presentation and therapeutic implications. <b>Methods:</b> A scoping review was conducted through a search of PubMed/MEDLINE, Scopus, and the Cochrane Library for studies published between January 1996 and May 2026. Studies describing pathophysiological variants, biomechanical mechanisms, nystagmus patterns, or therapeutic maneuvers in HSC-BPPV were included. A total of 26 studies met the inclusion criteria and underwent qualitative analysis. <b>Results:</b> Six principal mechanical configurations of horizontal canal positional vertigo were identified: long-arm canalolithiasis, short-arm canalolithiasis, canal-side cupulolithiasis, utricular-side cupulolithiasis, canalith jam, and light cupula. The available evidence suggests that these variants represent different mechanical states determined by otoconial location, otoconia-cupula interaction, canal obstruction, or alterations in cupula-endolymph density. This model explains the direction, intensity, and duration of positional nystagmus, the findings observed during the supine roll test and the bow and lean test, as well as the variability in response to repositioning maneuvers. A practical classification integrating pathophysiology, clinical findings, and treatment is proposed. <b>Conclusions:</b> HSC-BPPV may be more appropriately understood as a spectrum of mechanical states in which the configuration of otoconial debris and its interaction with the cupula influence the nystagmus pattern, clinical presentation, and therapeutic response. This integrative model may improve diagnostic accuracy and guide treatment selection, although prospective validation is required.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833390","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":"Internal Acoustic Meatus: Morphological Peculiarities and Clinical Implications.","authors":"Angela Babuci, Laila Ashkar, Zinovia Zorina, Svetlana Capcelea, Silvia Stratulat, Ilia Catereniuc, Lora Gitu, Doina Botnaru, Marin Buracovschi, Igor Cemortan, Nicolae Chele, Andrei Mostovei, Gabriela Motelica, Ion Dabija, Stanislav Strisca, Mihaela Dandara, Liliana Nastas, Sergiu Beliniuc, Elena Stepco, Svetlana Lozovanu, Olga Cheptanaru, Sofia Lehtman","doi":"10.3390/audiolres16040116","DOIUrl":"10.3390/audiolres16040116","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The variability of the internal acoustic meatus (IAM) and its morphological peculiarities are of high clinical significance in otologic interventions and neurosurgery. Considering the complexity of the neurovascular structures housed by the IAM, including passage of the facial nerve, the aim of the study was to highlight the morphological peculiarities of the IAM and their clinical significance. <b>Methods</b>: The age peculiarities of the IAM course were studied on 18 serially, transversely sectioned human embryos and fetuses, as well as on 20 newborn and 20 adult formalin-fixed hemiheads. The morphometric parameters of the IAM (width, height, length, and angles between the anterior and posterior walls of the IAM and the longitudinal axis of the petrous ridge (LAPR) were evaluated on 82 dry temporal bones. <b>Results</b>: In embryos and early fetal stages of development, the course of the IAM formed an acute, posteromedially open angle with the longitudinal axis of the petrous part of the temporal bone (LAP); in newborns, it was a right angle; in adults, it was an acute, anteromedially open angle. Various shapes of the IAO, such as oval (51.2%), semioval (23.2%), quadrangular (13.4%), heart-like (3.7%), and triangular (8.5%), were highlighted. The mean width of the internal acoustic opening (IAO) was 7.7 ± 2.11 mm (right/left-8.2 ± 2.22 mm/7.2 ± 1.89 mm), with a statistically significant difference (<i>p</i> = 0.031). The mean height of the IAO was 5.3 ± 1.43 mm (right/left-5.6 ± 1.58 mm/5.0 ± 1.22 mm), <i>p</i> = 0.082. The mean length of the IAM was 10.1 ± 2.83 (right/left-10.5 ± 2.96 mm/9.7 ± 2.67 mm), <i>p</i> = 0.214. A partial septum was revealed in 3.6% of cases, while total septation of the IAM was observed in 2.4%. The mean angle between the anterior wall of the IAM and the longitudinal axis of the petrous ridge (AWIAM/LAPR) was 21.4 ± 13.67° (right/left-22.2 ± 14.62°/20.5 ± 12.78°), <i>p</i> = 0.564. The mean angle between the posterior wall of the IAM and the longitudinal axis of the petrous ridge (PWIAM/LAPR) was 82.4 ± 8.02° (right/left-84.3 ± 7.93°/80.5 ± 7.76°); <i>p</i> = 0.032. <b>Conclusions</b>: In the initial stages of an individual's ontogenesis, the IAM forms an acute, posteromedially open angle with the LAP; in newborns-a right angle; in adults-an acute, anteromedially open angle. Both morphological characteristics and morphometric parameters of the IAO and IAM vary bilaterally. The oval, semioval, quadrangular, heart-like, and triangular shapes of the IAO were highlighted. Partial and total septation of the IAM were revealed. Only the TDAIO and PWIAM/LAPR angle were statistically significant, <i>p</i> < 0.05, while the bilateral correlation was negligible. The established morphological variants of the IAM could predispose to facial and vestibulocochlear nerve impairments.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833267","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":"Diabetes Mellitus as a Risk Factor in Recurrent Vestibular Disorders: An Update.","authors":"Athena Eliana Arsie, Carlotta Muneretto, Matteo Seno, Marta Gaffeo, Luca Sacchetto, Daniele Monzani, Silvia Palma","doi":"10.3390/audiolres16040115","DOIUrl":"10.3390/audiolres16040115","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Diabetes mellitus (DM) has been proposed as a potential risk factor for vestibular dysfunction, although the evidence remains heterogeneous. This review was prompted by the increasing recognition in clinical practice of a frequent coexistence between DM and recurrent vestibular disorders. It aims to examine the most recent available literature investigating the association between DM and the most common causes of recurrent vestibular disorders, thereby providing clinicians with additional insights for early diagnosis and risk stratification. <b>Methods</b>: A systematic review was conducted according to PRISMA guidelines with SWiM-based narrative synthesis. PubMed, Scopus, and Google Scholar were searched for studies (2016-2026) including adult diabetic patients with vestibular disorders. Risk of bias was assessed using NOS, RoB2, and JBI tools. <b>Results</b>: Twenty-nine studies met the inclusion criteria, but only nineteen were focused explicitly on recurrent vestibular disease. Diabetes was consistently associated with higher prevalence and recurrence of benign paroxysmal positional vertigo (BPPV), more persistent vestibular symptoms, and worse balance outcomes. Associations with other recurrent vestibular disorders was scarce and high heterogeneity limited quantitative synthesis. <b>Conclusions</b>: The available literature suggests that DM increases the vulnerability of the vestibular system in BPPV cases while data regarding other vestibular disorders, including VM and MD, are still limited. More prospective studies investigating the link between diabetes and recurrent vestibular disorders are needed, particularly through specific indicators of evolutionary picture of diabetes.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833277","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":"Age-Related Hearing Loss: Awareness, Perceptions, and Attitudes Among Adults in Saudi Arabia's Collective Healthcare Context.","authors":"Eman A Hajr, Haifa H Allahem, Aroob M Alromih, Amal A Alghtani, Abdullah Z Alshalan, Faisal N Almhesen, Abdulrahman A Hagr","doi":"10.3390/audiolres16040114","DOIUrl":"10.3390/audiolres16040114","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Age-related hearing loss (ARHL) is a major and growing public health concern, yet awareness of its nature, consequences, and management options remains inadequately studied in the Middle Eastern context. In Saudi Arabia, cochlear implantation is provided free of charge through the public healthcare system; however, adult uptake remains critically low, suggesting that awareness-rather than access-constitutes the primary barrier to timely intervention. In collective healthcare cultures, family members play a central role in healthcare decision-making for older individuals, making family-level awareness a critical determinant of early identification and treatment. This study aimed to assess public awareness, beliefs, and attitudes toward ARHL and its management options among adults in Saudi Arabia, applying the Health Belief Model (HBM) as a theoretical framework. <b>Methods:</b> A cross-sectional descriptive study was conducted using a structured questionnaire adapted from a previously validated survey, with cultural modifications for the Saudi context. The questionnaire was distributed electronically to adults aged 18 years and above across Saudi Arabia. A total of 506 consenting responses were included in the final analysis. Descriptive statistics were used to analyse frequencies, percentages, means, and standard deviations. <b>Results:</b> The majority of participants correctly identified hearing loss as a reduction in the ability to hear (84.6%), and 95.3% regarded good hearing as personally important. However, significant knowledge gaps were observed, with 53.8% believing hearing loss can be cured and 50.4% believing it can be halted. Notably, 34.2% believed cochlear implants benefit children exclusively. Doctors and the internet were the primary sources of medical information, yet 39.3% reported no preventive healthcare visits and 23.9% did not seek any information about hearing problems. When faced with a hypothetical hearing loss, 75.3% indicated they would consult an ENT specialist. <b>Conclusions:</b> Adults in Saudi Arabia demonstrate good awareness of the signs and consequences of hearing loss but exhibit significant knowledge gaps regarding its clinical course and available management options, most notably the belief that cochlear implantation is exclusively a pediatric intervention. These findings highlight the urgent need for culturally adapted awareness campaigns targeting family members of older adults, and support the development of community-based hearing health promotion strategies in Saudi Arabia and comparable collective healthcare societies.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833201","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":"Behavioral and Subjective Music Perception and Appreciation in Adults with Hearing Aids, Cochlear Implants, and Typical Hearing.","authors":"Stephanie Fowler-Brookman, Andrea D Warner-Czyz","doi":"10.3390/audiolres16040113","DOIUrl":"10.3390/audiolres16040113","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Even with the use of hearing aid or cochlear implant technologies, adults who are deaf or hard of hearing (DHH) exhibit difficulty perceiving musical characteristics compared to peers with typical hearing, but do not necessarily report a consistent decrease in appreciation of musical activities. This study addresses a gap in the literature by examining the effect of both hearing status (i.e., DHH versus typical hearing) and hearing technology (i.e., hearing aids versus cochlear implants) on both behavioral and subjective music abilities and ratings of music importance. <b>Methods</b>: Adults with typical hearing (n = 20), hearing aids (n = 10), or cochlear implants (n = 10) completed tasks on (a) behavioral measures of music perception including pitch perception, melody recognition, and timbre recognition; and (b) the Music-related Quality of Life questionnaire to assess subjective ratings of music abilities and music importance. <b>Results</b>: Adults with typical hearing outperformed the cochlear implant group on all behavioral music perception tasks, but they performed similarly to the hearing aid group. Although the two DHH groups subjectively rated their musical abilities less positively than adults with typical hearing, all three groups appraised the importance of music in their lives similarly. <b>Conclusions</b>: Music importance and appreciation do not depend on music abilities, implying that clinicians and researchers should incorporate metrics of subjective music quality of life to comprehensively assess and treat adults who are DHH to foster more positive quality of life.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833318","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":"Using 100 Hz Mastoid Vibration in Apogeotropic Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Diagnostic and Therapeutic Implications in a Retrospective Case-Control Study.","authors":"Giuseppe Santopietro, Luigi Califano, Iacopo Cangiano, Cataldo Latorre, Maria Grazia Melillo, Roberto Teggi","doi":"10.3390/audiolres16040112","DOIUrl":"10.3390/audiolres16040112","url":null,"abstract":"<p><p><b>Background</b>: Positional torsional downbeating nystagmus elicited during diagnostic maneuvers for posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV) may indicate either ipsilateral apogeotropic PSC-BPPV or contralateral anterior canal BPPV, making differential diagnosis challenging. This retrospective study evaluated whether ipsilateral 100 Hz mastoid vibration could facilitate conversion to a geotropic nystagmus pattern, thereby supporting both diagnosis and treatment. <b>Materials and Methods</b>: Ten patients with apogeotropic PSC-BPPV underwent standard diagnostic and therapeutic maneuvers combined with ipsilateral 100 Hz mastoid vibration. The primary outcome was the rate of nystagmus geotropization. Secondary outcomes included the number of repositioning maneuvers required to achieve complete symptom resolution. Outcomes were compared with those of two control groups: one consisting of patients with apogeotropic PSC-BPPV treated without mastoid vibration and another consisting of patients with typical PSC-BPPV treated using standard repositioning maneuvers alone. <b>Results</b>: Mastoid vibration induced geotropization in 7 out of 10 patients (70%). The mean number of liberatory maneuvers required for symptom resolution was lower in vibration-responsive patients than in vibration-non-responsive patients (1.7 ± 0.49 vs. 3.0 ± 1.41;). Compared with patients with apogeotropic PSC-BPPV treated without mastoid vibration, vibration-responsive patients required significantly fewer maneuvers (2.1 ± 0.87 vs. 2.9 ± 0.74; <i>p</i> = 0.036). No significant difference was observed when compared with patients with typical PSC-BPPV (2.1 ± 0.87 vs. 2.1 ± 0.52; <i>p</i> = 0.82). <b>Conclusions:</b> Mastoid vibration may represent a useful adjunctive tool in the management of apogeotropic PSC-BPPV by facilitating conversion to the typical geotropic pattern. This conversion may provide useful diagnostic information, and potentially reduce the number of repositioning maneuvers required to achieve symptom resolution.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833443","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":"Quantifying What Better-Ear PTA4 Does Not Capture: High-Frequency and Asymmetric Classification Discordance in Two Independent Adult Population Samples from Germany and the United States.","authors":"Peizheng Wang, Changgeng Mo, Shangqiguo Wang","doi":"10.3390/audiolres16040111","DOIUrl":"10.3390/audiolres16040111","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The four-frequency better-ear pure-tone average (PTA4; 0.5-4 kHz) is the dominant population definition of hearing impairment but underweights frequencies above 4 kHz and ignores interaural asymmetry. We quantified, in two independent adult samples, the proportion of PTA4-normal adults with elevated high-frequency or asymmetric profiles and whether this has a self-report correlate. <b>Methods:</b> Cross-sectional secondary analysis of two public datasets: the German HÖRSTAT/Aalen sample (2008-2012; <i>N</i> = 3105) and pooled US NHANES (2011-March 2020; <i>N</i> = 10,575; adults ≥ 20 years). The primary outcome, PTA4-discordant high-frequency loss, was defined a priori as better-ear PTA4 ≤ 25 dB HL with a better-ear 6-8 kHz mean (PTA68) > 25 dB HL, reported as the conditional proportion among PTA4-normal adults. Secondary outcomes were interaural asymmetry ≥ 15 dB and self-rated hearing trouble (NHANES AUQ054 ≥ 3). <b>Results:</b> Among PTA4-normal adults, 34.3% (95% CI 32.5-36.2) of the German sample and a survey-weighted 28.2% (25.9-30.5) of the NHANES sample had PTA68 > 25 dB HL. Prevalence rose with age (≈three-fold odds per decade; two-fold for male sex; all <i>p</i> < 0.001). Of those with PTA68 asymmetry ≥ 15 dB, 75-85% remained PTA4-normal, although the more stringent unilateral-like pattern was rare (1.5-1.7%). Self-reported trouble was elevated in PTA4-discordant mild (OR 2.56) and strong (OR 3.50) groups (OR 1.43 per 10 dB PTA68). <b>Conclusions:</b> Although disagreement between the two classifications is arithmetically expected, since they cover different frequencies, its magnitude is substantial and reproducible: roughly a quarter to a third of PTA4-normal adults (28-34%) carry an elevated PTA68, with a graded self-report correlate consistent with early high-frequency presbyacusis, and the same age structure emerges in two samples measured with different equipment and procedures. Because the 25 dB HL criterion is not age-referenced, an increasing share of the discordance at older ages represents expected presbyacusis rather than pathology, so the older-age figures should be read as counts above a fixed public-health threshold. Reporting a high-frequency companion metric (PTA68 or PTA346) alongside PTA4 would make this information visible without displacing the existing system.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13510126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833405","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 Listener Position on Speech Recognition in a Simulated Multitalker Environment.","authors":"William J Bologna, Courtney King, Katie Esser, Elaine V Shaw, Karina M Ball","doi":"10.3390/audiolres16040109","DOIUrl":"10.3390/audiolres16040109","url":null,"abstract":"<p><p><b>Background/Objectives</b>: A listener's physical position in a realistic environment influences the intensity of speech and noise that arrives at the two ears as well as the binaural cues available for the segregation of target signals from background noise. The purpose of this paper was to evaluate how listener position influences speech recognition in a simulated multitalker environment and to determine the extent to which strategic positioning can be leveraged to improve communication in the real world. <b>Methods</b>: Virtual acoustics were used to generate a realistic simulation of a restaurant with 12 different listener positions, which were distributed across four different tables. Speech recognition in each simulated position was measured in 64 listeners separated into two age groups (younger and older) with varying degrees of hearing sensitivity represented in both groups. <b>Results</b>: Significant differences in speech recognition were observed between tables and between seats at each table, indicating that even subtle changes in listener position can yield meaningful effects on speech recognition. The best positions tended to contain asymmetric distributions of maskers on either side of the listener, and they afforded access to spatial cues for segregation of the target from nearby maskers. Age and hearing sensitivity also contributed to speech recognition thresholds and interacted with the effects of listener position. <b>Conclusions</b>: Manipulations of listener position may be an effective way to improve communication in realistic environments. Future work is needed to develop generalizable strategies to guide patients on how to identify positions that are optimal for speech understanding in any given environment.</p>","PeriodicalId":44133,"journal":{"name":"Audiology Research","volume":"16 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13509616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833275","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}