Journal of the American Academy of Audiology最新文献

{"title":"Towards Policy Integration of Vestibular Management in Pediatric Hearing Health Care: Global Service Delivery Gaps with Relevance to Low-Income and Middle-Income Countries.","authors":"Katijah Khoza-Shangase, Ayanda Gina, Sphilile Mbhele","doi":"10.3766/jaaa.250099","DOIUrl":"10.3766/jaaa.250099","url":null,"abstract":"<p><strong>Background: </strong>Vestibular dysfunction (VD) is a common yet often overlooked comorbidity in children with hearing loss, particularly those with sensorineural hearing loss (SNHL), congenital anomalies, or cochlear implants. These challenges are global, but they are especially critical in low- and middle-income countries (LMICs), including South Africa, where diagnostic resources and service integration are limited. Motor development, gaze stability, school performance, and quality of life (QoL) are affected by VD, yet it is seldom included in pediatric hearing health-care frameworks or routine clinical practice.</p><p><strong>Purpose: </strong>This review synthesizes global evidence of VD in children with hearing loss and examines how vestibular care is integrated into pediatric audiology with a focus on service delivery gaps and policy implications in LMIC contexts.</p><p><strong>Methods: </strong>A narrative review of peer-reviewed literature (2015-2025) was conducted using databases including PubMed, Scopus, and Web of Science. Twenty studies met the inclusion criteria and were thematically analyzed for prevalence, assessment and management practices, developmental impacts, and policy considerations.</p><p><strong>Results: </strong>An estimated 20 to 85 percent of children with hearing loss, depending on diagnostic tools, age, and underlying etiology, are affected by VD, which contributes to delayed motor milestones, reduced balance control, learning challenges, and poorer psychosocial adjustment. Despite the prevalence and developmental impact of VD, vestibular care remains inconsistently implemented worldwide. Major gaps persist in pediatric-appropriate diagnostic protocols, rehabilitation strategies, workforce training, and policy integration. These limitations are most pronounced in LMICs, where audiology services are often constrained by limited infrastructure and competing health priorities.</p><p><strong>Conclusions: </strong>Integrating vestibular assessment and management into pediatric audiology represents a critical step toward comprehensive and equitable child hearing health care. Coordinated policy development, capacity building, and context-adapted clinical pathways are urgently required to close this gap globally.</p><p><strong>Clinical relevance statement: </strong>This review highlights the importance of incorporating vestibular considerations into pediatric audiology practice. Feasible screening and rehabilitation strategies may improve developmental outcomes, enhance educational participation, and strengthen more holistic and multidisciplinary models of care for children with hearing loss.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"379-396"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Affected Semicircular Canal and Functional Limitations and Anxiety in Benign Paroxysmal Positional Vertigo.","authors":"Gamze Nas Özütemiz, Evren Hızal, Anı Parabakan Polat, Berna Deniz Kuntman, Adnan Fuat Büyüklü, Caner İncekaş","doi":"10.3766/jaaa.250098","DOIUrl":"10.3766/jaaa.250098","url":null,"abstract":"<p><strong>Background: </strong>Benign paroxysmal positional vertigo (BPPV) causes functional limitations in activities of daily living, increases the risk of falls, and leads to increased anxiety.</p><p><strong>Purpose: </strong>To assess the relationship between the plane of the affected semicircular canal and functional limitations, fall risk, and anxiety in patients with BPPV.</p><p><strong>Research design: </strong>The Vestibular Disorders Activities of Daily Living Scale (VADL), the Berg Balance Scale (BBS), and the Hamilton Anxiety Rating Scale (HAM-A) were administered to patients with BPPV with single-canal involvement who were treated with canalith repositioning maneuvers. Patients with multicanal involvement were not included in the study. Scores were compared among posterior, lateral, and anterior canal BPPV groups.</p><p><strong>Study sample: </strong>Adults aged 18-65 years presenting with vertigo and diagnosed with BPPV between May and October 2021 were included.</p><p><strong>Data collection and analysis: </strong>Group differences among canal subtypes were evaluated using the Kruskal-Wallis test. Between-group comparisons among canal groups were further examined with a one-way analysis of covariance adjusted for age and sex. Bonferroni correction was applied for post hoc pairwise comparisons. For categorical variables, between-group differences were assessed with Pearson's χ² test.</p><p><strong>Results: </strong>Patients with anterior canal BPPV had significantly lower VADL scores, whereas HAM-A and BBS scores did not differ by canal involvement. Women showed higher anxiety and fall risk scores, and the oldest age group had lower BBS scores.</p><p><strong>Conclusions: </strong>According to VADL scores, anterior canal BPPV was associated with less functional limitation than posterior or lateral canal BPPV. Anxiety and fall risk scores showed no canal-related differences.</p><p><strong>Clinical relevance statement: </strong>Clinicians can use the canal plane to set expectations for daily function recovery while prioritizing fall prevention strategies irrespective of canal.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"309-318"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Simulation-Based Training on Audiology Students' Professional Competences: A Pilot Randomized Study.","authors":"Noura I Alothman, Ahmad A Alanazi, Rawan A AlQarni, Nisreen N AlAwaji","doi":"10.3766/jaaa.250114","DOIUrl":"10.3766/jaaa.250114","url":null,"abstract":"<p><strong>Background: </strong>Developing professional competencies such as empathy, counseling, and communication is an essential yet often underemphasized aspect of audiology education. Traditional instruction may provide theoretical knowledge but limited opportunity for experiential practice in emotionally charged clinical situations, such as delivering bad news to patients and families.</p><p><strong>Purpose: </strong>We compared the impact of simulation-based training and case scenario discussions on audiology students' confidence in professional competencies.</p><p><strong>Research design: </strong>We used a randomized controlled pre- and posttest study design. All participants attended a 1-hour lecture on counseling strategies for delivering bad news and completed a professional competence confidence questionnaire before and after the intervention.</p><p><strong>Study sample: </strong>Sixteen undergraduate audiology students enrolled in a single university program were randomly assigned to either the simulation group (n = 8) or the case-scenario discussion control group (n = 8).</p><p><strong>Intervention: </strong>The experimental group engaged in a live simulation with standardized patients, whereas the control group viewed recorded case scenarios; both groups participated in guided debriefing sessions.</p><p><strong>Data collection and analysis: </strong>Self-reported confidence levels across domains of empathy, professionalism, and provision of support/resources were measured using a validated questionnaire. Pre- and postintervention scores were analyzed within groups using the Wilcoxon signed-rank test and between groups using the Mann-Whitney <i>U</i> test, with significance set at p < 0.05.</p><p><strong>Results: </strong>Despite the small sample size, students in the simulation group demonstrated statistically significant gains in confidence across empathy, professionalism, and supportive communication skills (p < 0.05), whereas the control group showed modest improvements limited to support and resources.</p><p><strong>Conclusions: </strong>Simulation-based training was more effective than case-scenario observation, even when observation was paired with structured debriefing, highlighting the added value of hands-on, experiential participation.</p><p><strong>Clinical relevance statement: </strong>Integrating simulation into audiology curricula offers a practical method to strengthen students' interpersonal and counseling skills in emotionally sensitive situations. These findings highlight the potential of simulation as a scalable and evidence-informed strategy to improve clinical readiness and patient-centered communication in audiological practice.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"298-308"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audiologist Decision-Making: Hearing Aid Technology Levels and Auditory Ecology.","authors":"Rachael Pennock, Pamela Souza","doi":"10.3766/jaaa.250077","DOIUrl":"10.3766/jaaa.250077","url":null,"abstract":"<p><strong>Background: </strong>Audiologists are expected to use evidence-based practices to guide their decision-making practices and recommendations regarding specific hearing aid technology for each patient. However, guidance regarding how to make these decisions is limited and sometimes conflicting. Hearing aid manufacturers have promoted the idea that an individual's auditory ecology, which refers to their listening demands and environments, may contribute to interpatient differences in outcomes and benefits of specific technology. How the limited and conflicting evidence surrounding technology levels and auditory ecology impacts audiologists' decision-making is unknown.</p><p><strong>Purpose: </strong>We sought to understand audiologists' decision-making practices, including how they assess patients' auditory ecologies and apply the results of such assessments to their decisions.</p><p><strong>Research design: </strong>An online survey was sent to audiologists across the United States. The 21 survey questions covered respondent demographics, the hearing aid selection process, use of auditory ecology, and patients' success with hearing aids.</p><p><strong>Study sample: </strong>Survey respondents were clinical audiologists. A total of 185 completed surveys were included in the analysis.</p><p><strong>Data collection and analysis: </strong>The results of each topic area were summarized descriptively and investigated inferentially.</p><p><strong>Results: </strong>Most participants reported that a patient's listening demands and environments were the most important considerations when selecting the technology level. The most popular method of evaluating a patient's auditory ecology was a clinical interview. Most audiologists reported recommending higher-level technology for patients with more active lifestyles and lower-level technology for patients with calmer lifestyles.</p><p><strong>Conclusions: </strong>Audiologists reported prioritizing auditory ecology when selecting a technology level and using many different methods, sometimes in combination, to evaluate the auditory ecology of their patients. Clinician factors did not impact the use of auditory ecology or how they recommended technology levels. The use of auditory ecology did not impact return/exchange rates.</p><p><strong>Clinical relevance statement: </strong>Most audiologists have adopted a recommendation pattern of encouraging higher technology levels for patients who report more demanding listening environments and needs. More research is needed to gain a better understanding of the nuances of clinical interviews and unique practice approaches to evaluate auditory ecology.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"280-297"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular Function in Judo Athletes: Evidence of Subclinical Vestibular Dysfunction.","authors":"Nizamettin Burak Avcı, Simay Kaplan, Ayşegül Eymen Puşulu, Nurhan Tosun, Meltem Nazıroğlu, İlknur Taşdemir Gürşen, Gülçin Hançer Arslan, Şengül Demiral, Erdoğan Bulut","doi":"10.3766/jaaa.250118","DOIUrl":"10.3766/jaaa.250118","url":null,"abstract":"<p><strong>Background: </strong>Judo is a dynamic combat sport demanding high levels of balance, agility, postural control, and kinesthetic awareness. The vestibular system plays a vital role in maintaining balance and spatial orientation, integrating sensory inputs essential for judo performance. However, few studies have directly examined vestibular function in judo athletes, despite their frequent exposure to head impacts and rapid rotational movements that may affect vestibular integrity.</p><p><strong>Purpose: </strong>This study aimed to compare the vestibular functions of active judo athletes with those of healthy controls.</p><p><strong>Research design: </strong>A cross-sectional comparative design was employed.</p><p><strong>Study sample: </strong>The study included 26 professional judo athletes (aged 18-23 years, ≥5 years of training experience) and 23 age- and sex-matched healthy controls.</p><p><strong>Data collection and analysis: </strong>Vestibular function was assessed using the video head impulse test for semicircular canal function and cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP) for otolith organ function. The Post-Concussion Symptom Scale (PCSS) was administered to athletes to assess potential symptoms related to prior minor head impacts. Group comparisons were analyzed using independent-samples <i>t</i> tests, and Pearson correlation analysis examined relationships between vestibular outcomes, PCSS scores, and years of training.</p><p><strong>Results: </strong>Judo athletes demonstrated significantly reduced vestibulo-ocular reflex (VOR) gains across all semicircular canals compared with controls (p < 0.05). No significant differences were observed between groups in cVEMP and oVEMP parameters (p > 0.05). PCSS scores were not correlated with vestibular test outcomes or training duration (p > 0.05).</p><p><strong>Conclusions: </strong>These findings suggest that judo-induced microtraumas may selectively affect semicircular canal function while sparing otolith organ responses. The subclinical decrease in VOR gains in athletes suggests that repeated head accelerations and rotational movements may lead to subclinical VOR alterations even in the absence of overt symptoms.</p><p><strong>Clinical relevance statement: </strong>Subclinical vestibular alterations in athletes may contribute to balance instability and increase injury risk. Routine vestibular screening in contact-sport athletes could support early detection, targeted rehabilitation, and improved long-term postural control.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"356-362"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents' Attitudes and Perceptions Toward Peers with Hearing Aids: The Hearing Aid Effect in the Mid-2020s.","authors":"Anı Parabakan Polat, Elif Ece Çocar, Sude Pamuk, Tuğba Nezahat Bozkaya, Volkan Türkmen","doi":"10.3766/jaaa.250109","DOIUrl":"10.3766/jaaa.250109","url":null,"abstract":"<p><strong>Background: </strong>Negative perceptions related to appearance, personality, and intelligence may exist among peers toward adolescents who use hearing aids. This phenomenon, known as the \"hearing aid effect,\" may discourage adolescents from using their devices. Understanding peers' attitudes and perceptions is crucial for promoting social acceptance and developing educational programs that foster positive perceptions of hearing aid users.</p><p><strong>Purpose: </strong>This study aimed to examine adolescents' attitudes and perceptions toward peers using hearing aids and to investigate the relationship between adolescents' encounters with individuals with disabilities or hearing aids and their attitudes and perceptions.</p><p><strong>Research design: </strong>Correlational, cross-sectional research.</p><p><strong>Study sample: </strong>A total of 146 adolescents aged 10-18 years participated in this study.</p><p><strong>Data collection and analysis: </strong>Participants completed the Hearing Aid Effect Questionnaire and the Encounters with Individuals with Disabilities and Hearing Aids Questionnaire. The Hearing Aid Effect Questionnaire included photographs of peers using hearing aids and peers with typical hearing. Differences in peer perception, social acceptance, and perceived difference were examined. Relationships between total and subscale scores of the Hearing Aid Effect Questionnaire and frequency of encounters with individuals with disabilities and hearing aids were also analyzed.</p><p><strong>Results: </strong>Significant differences were found between adolescents' perceptions of peers using hearing aids and peers with typical hearing in peer perception (p = 0.000), perceived difference (p = 0.001), and total score (p = 0.004) of the Hearing Aid Effect Questionnaire. A positive correlation was found between the social acceptance subscale score for peers with cochlear implants and the frequency of encounters with individuals with disabilities (ρ = 0.164, p = 0.047).</p><p><strong>Conclusions: </strong>Adolescents have more negative perceptions of peers using hearing aids compared with peers with typical hearing and tend to view these peers as different from themselves.</p><p><strong>Clinical relevance statement: </strong>Regular use of hearing aids significantly influences literacy, academic performance, and social development. Negative attitudes and perceptions of peers toward adolescents who use hearing aids may lead these adolescents to conceal their devices and discourage them from seeking amplification. The findings of our study will guide audiologists in designing programs to establish supportive peer environments for adolescents with hearing aids.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"319-329"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pupillometry Reflects Listening Effort as a Function of Talker in the AzBio Sentences.","authors":"Nicholas Giuliani, Stephanie Panoncillo","doi":"10.3766/jaaa.250026","DOIUrl":"10.3766/jaaa.250026","url":null,"abstract":"<p><strong>Background: </strong>Pupillometry, or the quantification of pupil size, reflects a variety of processes involved in listening effort and is sensitive to many cognitive demands even when word recognition abilities are high. However, it is uncommon for studies to use clinical tests to examine listening effort, which increases barriers for audiologists seeking to apply this information to their clinical practice. The AzBio sentences present a unique opportunity to use a clinical test to categorize a common concern reported by patients: certain talkers are more difficult to understand than others.</p><p><strong>Purpose: </strong>The purpose of this exploratory study was to parse the effects of condition (i.e., quiet vs. 10-talker babble), hearing status, and talker on listening effort by using pupillometry.</p><p><strong>Research design: </strong>Within-participants cross-sectional design.</p><p><strong>Study sample: </strong>Fifty-one adults were recruited for this prospective study. Twenty-two participants had no hearing loss, and 29 exhibited a three-frequency (1000-, 2000-, and 4000-Hz) pure tone average greater than 20 decibels hearing level (dB HL) but less than 70 dB HL. Of the participants with hearing loss, 18 wore hearing aids.</p><p><strong>Data collection and analysis: </strong>Changes in pupil dilation were measured using a remote eye tracker as participants listened to and repeated back AzBio sentences spoken by four distinct talkers: Male1, Male2, Female1, and Female2. Statistical analyses were performed on pupil dilation using linear mixed effects modeling and growth curve analysis (GCA).</p><p><strong>Results: </strong>Peak pupil dilation was largest for the participants with hearing loss who did not wear hearing aids. Peak dilations were also largest when participants listened to Male1 in 10-talker babble. GCA demonstrated that mean pupil diameter was larger for both male talkers than for the female talkers, and the linear growth rate of pupil dilation was significantly slower for participants without hearing loss.</p><p><strong>Conclusions: </strong>This study demonstrated that despite high word recognition abilities, unaided hearing loss and specific male talkers increased listening effort when participants listened to AzBio sentences.</p><p><strong>Clinical relevance statement: </strong>These results will be of interest to clinicians who are interested in learning about how listening effort contributes to patient-reported difficulties in clinical practice.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"343-355"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Age, Auditory Performance, and Quality of Life in Middle-Aged and Older Cochlear Implant Users.","authors":"Hüseyin Deniz","doi":"10.3766/jaaa.250085","DOIUrl":"10.3766/jaaa.250085","url":null,"abstract":"<p><strong>Background: </strong>Aging can result in hearing loss, and cochlear implants (CIs) provide an effective means for auditory rehabilitation. We evaluated the impact of age on CI outcomes.</p><p><strong>Purpose: </strong>This study aimed to examine the effects of aging on auditory performance and quality of life in individuals who underwent unilateral cochlear implantation.</p><p><strong>Research design: </strong>This study was designed as a cross-sectional study.</p><p><strong>Study sample: </strong>Participants included individuals with postlingual, profound sensorineural hearing loss who had undergone unilateral cochlear implantation. Two groups were formed: those aged 40-59 years (Group 1) and those aged ≥60 years (Group 2). There were 31 participants in Group 1 and 33 participants in Group 2, totaling 64 participants (30 women [46.88 percent] and 34 men [53.13 percent]).</p><p><strong>Intervention: </strong>Quality of life was measured using the Turkish version of The World Health Organization Quality of Life Brief Version (WHOQOL-BREF), and depression levels were assessed using Beck's Depression Inventory. To assess auditory performance, free-field audiometry included pure-tone threshold at 0.5-4 kHz, speech recognition threshold, speech discrimination, and spectral-temporally modulated ripple test measurements.</p><p><strong>Data collection and analysis: </strong>The Shapiro-Wilk test was used to assess the normality of the numerical variables. The Mann-Whitney <i>U</i> test was used to compare WHOQOL-BREF scores and auditory performance between groups, and the chi-square test was used for categorical variables. Relationships between numerical variables were assessed using Spearman's correlation coefficient.</p><p><strong>Results: </strong>The older group exhibited significantly poorer auditory performance and quality of life scores across multiple dimensions (p < 0.05). However, no significant differences in depression levels were observed between the groups (p = 0.198).</p><p><strong>Conclusions: </strong>Age considerably influences auditory performance and quality of life in CI users. These findings underscore the importance of tailored rehabilitation approaches for this population.</p><p><strong>Clinical relevance statement: </strong>The results of this study show that aging negatively affects the auditory performance and quality of life of CI users. Moreover, CI alone is insufficient to fully improve quality of life in older individuals, highlighting the need for a comprehensive, multidisciplinary approach to address aging-related neurological and sensory changes.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"330-342"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Bisphosphonate Therapy on Hearing and Middle Ear Dysfunction in Pediatric Osteogenesis Imperfecta.","authors":"Kamron Zand, Megan Gillespie, Marco Braaten, Junghyae Lee, Matthew VanOrmer, Cindy Johnson, Ryan Sewell, Maegen Wallace","doi":"10.3766/jaaa.250042","DOIUrl":"10.3766/jaaa.250042","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a heterogeneous inherited connective tissue disorder characterized by impaired bone matrix formation. Hearing loss is observed in 28 to 65 percent of patients with OI. Most patients with OI experience conductive hearing loss (CHL); however, mixed and sensorineural (SNHL) hearing loss has also been described.</p><p><strong>Purpose: </strong>The primary aim of this retrospective study was to characterize the rates of middle ear dysfunction (MED) and hearing loss (HL) with pediatric OI and investigate the efficacy of bisphosphonate therapy in HL.</p><p><strong>Research design: </strong>Retrospective chart review of pediatric patients with OI.</p><p><strong>Study sample: </strong>Pediatric patients with OI treated between January 2000 and January 2021 were included. HL was defined according to pure tone audiometry, while MED was determined by tympanometry at 226 Hz. Patients were categorized by the OI type and considered to be using bisphosphonates if they had been initiated within 1 year prior to testing.</p><p><strong>Intervention: </strong>No direct intervention was performed. Comparisons between bisphosphate use and no bisphosphonate use were explored.</p><p><strong>Data collection and analysis: </strong>The chi-square test was utilized for categorical data to investigate whether a significant association with two-by-two variables existed.</p><p><strong>Results: </strong>This study included 144 patients. Of these patients, 12.5 percent had HL. Tympanometry revealed that 25 percent had MED. Additionally, 82.6 percent were currently using bisphosphonates. Across all OI types, no association between current bisphosphonates and HL or MED was observed. However, a subanalysis of patients with type I OI indicated that the absence of MED was statistically associated with current bisphosphonate therapy (p = 0.025).</p><p><strong>Conclusion: </strong>Bisphosphonates are associated with the absence of MED in pediatric patients with type I OI. Because of its mild disease course, bisphosphonates are not commonly used for many patients with type I OI. By reducing MED and its associated comorbidities, our results suggest that bisphosphonate use may confer a significant therapeutic benefit.</p><p><strong>Clinical relevance statement: </strong>HL is common in individuals with OI. Our study suggests that initiating bisphosphates at an earlier age may delay middle ear changes that contribute to HL.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"273-279"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Functional Hearing Difficulties Using Low-Gain Amplification: Case Reports on Auditory Processing Evaluations.","authors":"Alyssa J Davidson, Rebecca Bieber, Kimberly Jenkins","doi":"10.3766/jaaa.250023","DOIUrl":"10.3766/jaaa.250023","url":null,"abstract":"<p><strong>Background: </strong>Functional hearing difficulties are common among both the civilian population and military personnel with hearing thresholds less than 25 dB HL, particularly those exposed to blasts or with mild traumatic brain injuries (mTBIs). These individuals often report significant hearing challenges in noisy environments, despite \"normal\" audiometric thresholds. Low-gain hearing aids (LGHAs) have emerged as a promising intervention for managing these difficulties.</p><p><strong>Purpose: </strong>Describe the decision-making process for identifying a candidate for LGHAs and evaluate the outcomes.</p><p><strong>Research design: </strong>Case reports.</p><p><strong>Study sample: </strong>Three case reports of service members: two male and one female.</p><p><strong>Data collection and analysis: </strong>Three case reports who underwent auditory processing evaluations are presented to illustrate clinical decision-making and outcomes for patients with hearing thresholds less than 25 dB HL and functional hearing difficulties, highlighting the potential benefits and limitations of LGHAs.</p><p><strong>Results: </strong>Patient 1 exhibited improvement in functional hearing difficulties supported by standardized questionnaire results. Patient 2 initially struggled with hearing aid use but experienced significant benefit after device adjustments and counseling, as evidenced by increased usage and improved handicap scores. Patient 3, whose difficulties were attributed primarily to comorbid conditions rather than auditory system abnormalities, was referred for management of these conditions before any audiological intervention.</p><p><strong>Conclusions: </strong>These cases highlight the importance of individualized assessment and treatment strategies for optimizing outcomes. LGHAs are a feasible intervention for individuals with \"normal\" hearing thresholds who experience significant communication difficulties, particularly in challenging listening environments. These devices can provide measurable benefits, such as improved perceived speech understanding and reduced hearing handicap, making them a valuable option for this population.</p><p><strong>Clinical relevance statement: </strong>LGHAs offer a viable and measurable treatment option for patients with \"normal\" hearing thresholds who experience functional hearing difficulties, especially in noise. These case reports demonstrate how individualized assessment and device counseling can lead to improved communication outcomes, encouraging clinicians to consider amplification as part of a broader management strategy for this underserved population.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"37 4","pages":"363-378"},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}