Ear and Hearing最新文献

{"title":"Wearing Hearing Protection Makes Me Worse at My Job: Impacts of Hearing Protection Use on Sensorimotor Tracking Performance.","authors":"Matthew G Wisniewski, C Shane Chuwonganant","doi":"10.1097/AUD.0000000000001630","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001630","url":null,"abstract":"<p><strong>Objectives: </strong>Occupational hearing loss is a significant problem worldwide despite the fact that it can be mitigated by the wearing of hearing protection devices (HPDs). When surveyed, workers frequently report that worsened work performance while wearing HPDs is one reason why they choose not to wear them. However, there have been few studies to supplement these subjective reports with objective measures. Where they do exist, assessed performance measures have mostly characterized auditory situational awareness in gross terms (e.g., average speech comprehension scores over an entire session). The temporal dynamics of performance and HPD impacts on nonauditory aspects of work performance are largely unknown. In the present study, we aimed to fill this gap in the literature by measuring how HPD usage impacted sensorimotor tracking performance in relation to ongoing auditory events.</p><p><strong>Design: </strong>In two experiments, listeners heard commands sourced from the coordinate response measure (CRM) corpus (i.e., sentences of the form \"Ready <call sign> go to <color> <number> now\"). These commands informed listeners of which of nine moving on-screen objects to track with a computer mouse (e.g., \"blue four\" refers the listener to a blue square). The commands were presented in background street noise and were heard under either \"No HPD\" or \"HPD\" conditions. In experiment 1, HPD wearing was simulated with a digital filter designed to mimic the attenuation profile of a passive HPD. In experiment 2, actual HPDs were worn by listeners. Continuous recording of tracking error allowed us to simultaneously examine how HPD wearing impacted speech comprehension, the accuracy of tracking, and how tracking accuracy varied as a function of time on task and ongoing auditory events (e.g., the presentation of a critical CRM sentence).</p><p><strong>Results: </strong>In both experiments, listeners spent less time tracking the correct object in the HPD condition. After trimming data to those time points in which the target object was known, worse performance was exhibited by the HPD condition than the No HPD condition. In the examination of the temporal dynamics of tracking error, it was apparent that differences arose strongly during the presentation of CRM sentences.</p><p><strong>Conclusions: </strong>Workers' complaints of poorer performance while wearing HPDs are justified and extend beyond just diminished auditory situational awareness. The negative impact on nonauditory aspects of work performance may be strongest around critical listening periods. Addressing these aspects of performance will be an important part of addressing HPD nonuse in occupational settings.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning-Based Diagnosis of Chronic Subjective Tinnitus With Altered Cognitive Function: An Event-Related Potential Study.","authors":"Jihoo Kim, Kang Hyeon Lim, Euijin Kim, Seunghu Kim, Hong Jin Kim, Ye Hwan Lee, Sungkean Kim, June Choi","doi":"10.1097/AUD.0000000000001623","DOIUrl":"10.1097/AUD.0000000000001623","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Due to the absence of objective diagnostic criteria, tinnitus diagnosis primarily relies on subjective assessments. However, its neuropathological features can be objectively quantified using electroencephalography (EEG). Despite the existing research, the pathophysiology of tinnitus remains unclear. The objective of this study was to gain a deeper comprehension of the neural mechanisms underlying tinnitus through the comparison of cognitive event-related potentials in patients with tinnitus and healthy controls (HCs). Furthermore, we explored the potential of EEG-derived features as biomarkers for tinnitus using machine learning techniques.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Forty-eight participants (24 patients with tinnitus and 24 HCs) underwent comprehensive audiological assessments and EEG recordings. We extracted N2 and P3 components of the midline electrodes using an auditory oddball paradigm, to explore the relationship between tinnitus and cognitive function. In addition, the current source density for N2- and P3-related regions of interest was computed. A linear support vector machine classifier was used to distinguish patients with tinnitus from HCs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The P3 peak amplitudes were significantly diminished in patients with tinnitus at the AFz, Fz, Cz, and Pz electrodes, whereas the N2 peak latencies were significantly delayed at Cz electrode. Source analysis revealed notably reduced N2 activities in bilateral fusiform gyrus, bilateral cuneus, bilateral temporal gyrus, and bilateral insula of patients with tinnitus. Correlation analysis revealed significant associations between the Hospital Anxiety and Depression Scale-Depression scores and N2 source activities at left insula, right insula, and left inferior temporal gyrus. The best classification performance showed a validation accuracy of 85.42%, validation sensitivity of 87.50%, and validation specificity of 83.33% in distinguishing between patients with tinnitus and HCs by using a total of 18 features in both sensor- and source-level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrated that patients with tinnitus exhibited significantly altered neural processing during the cognitive-related oddball paradigm, including lower P3 amplitudes, delayed N2 latency, and reduced source activities in specific brain regions in cognitive-related oddball paradigm. The correlations between N2 source activities and Hospital Anxiety and Depression Scale-Depression scores suggest a potential link between the physiological symptoms of tinnitus and their neural impact on patients with tinnitus. Such findings underscore the potential diagnostic relevance of N2- and P3-related features in tinnitus, while also highlighting the interplay between the temporal lobe and occipital lobe in tinnitus. Furthermore, the application of machine learning techniques has shown reliable results in distinguishing tinnitus patients from HCs, reinforcing the v","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of Cochlear Implantation and Hearing Preservation for Children With Preoperative Functional Hearing: A Prospective Clinical Trial.","authors":"Lisa R Park, Margaret E Richter, Erika B Gagnon, Shannon R Culbertson, Lillian W Henderson, Margaret T Dillon","doi":"10.1097/AUD.0000000000001636","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001636","url":null,"abstract":"<p><strong>Objectives: </strong>This study was designed to (1) compare preactivation and postactivation performance with a cochlear implant for children with functional preoperative low-frequency hearing, (2) compare outcomes of electric-acoustic stimulation (EAS) versus electric-only stimulation (ES) for children with versus without hearing preservation to understand the benefits of low-frequency acoustic cues, and (3) to investigate the relationship between postoperative acoustic hearing thresholds and performance.</p><p><strong>Design: </strong>This was a prospective, 12-month between-subjects trial including 24 pediatric cochlear implant recipients with preoperative low-frequency functional hearing. Participant ages ranged from 5 to 17 years old. They were recruited at their device activation and fit with EAS or ES based on their postoperative thresholds. Group outcomes were compared for single-word recognition, masked sentence recognition, perceived hearing abilities, speech production, receptive language, expressive language, and prosodic identification.</p><p><strong>Results: </strong>Children experienced improvements in word recognition, subjective hearing, speech production, and expressive language with EAS or ES as compared with their preoperative abilities. Children using EAS performed better on a prosodic identification task and had higher subjective hearing scores postactivation as compared with children using ES. There was a significant relationship between postoperative thresholds at 125 Hz and prosodic identification.</p><p><strong>Conclusions: </strong>The results of this study support cochlear implantation for children with normal-to-moderate low-frequency hearing thresholds and severe-to-profound high-frequency hearing loss. They also highlight the benefits of postoperative hearing preservation for language development.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Early Progress in Adult Cochlear Implant Outcomes.","authors":"Mathieu Marx, Marie-Laurence Laborde, Carol Algans, Marjorie Tartayre, Chris J James","doi":"10.1097/AUD.0000000000001559","DOIUrl":"10.1097/AUD.0000000000001559","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Adult cochlear implant (CI) recipients obtain varying levels of speech perception from their device. Adult CI users adapt quickly to their CI if they have no peripheral \"bottom-up\" or neurocognitive \"top-down\" limiting factors. Our objective here was to understand the influence of limiting factors on the progression of sentence understanding in quiet and in noise, initially and over time. We hypothesized that the presence of limiting factors, detected using a short test battery, would predictably influence sentence recognition with practical consequences. We aimed to validate the test battery by comparing the presence of limiting factors and the success criteria of &gt;90% sentence understanding in quiet 1 month after activation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;The study was a single-clinic, cross-sectional, retrospective design incorporating 32 adult unilateral Nucleus CI users aged 27 to 90 years (mean = 70, SD = 13.5). Postoperative outcome was assessed through sentence recognition scores in quiet and in varying signal to noise ratios at 1 day, 1 to 2 months, and up to 2 years. Our clinic's standard test battery comprises physiological and neurocognitive measures. Physiological measures included electrically evoked compound action potentials for recovery function, spread of excitation, and polarity effect. To evaluate general cognitive function, inhibition, and phonological awareness, the Montreal Cognitive Assessment screening test, the Stroop Color-Word Test, and tests 3 and 4 of the French Assessment of Reading Skills in Adults over 16 years of age, respectively were performed. Physiological scores were considered abnormal, and therefore limiting, when total neural recovery periods and polarity effects, for both apical and basal electrode positions, were &gt;1.65 SDs from the population mean. A spread of excitation of &gt;6 electrode units was also considered limiting. For the neurocognitive tests, scores poorer than 1.65 SDs from published normal population means were considered limiting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At 1 month, 13 out of 32 CI users scored ≥90% sentence recognition in quiet with no significant dependence on age. Subjects with no limiting peripheral or neurocognitive factors were 8.5 times more likely to achieve ≥90% score in quiet at 1 month after CI switch-on ( p = 0.010). In our sample, we detected 4 out of 32 cases with peripheral limiting factors that related to neural health or poor electrode-neural interface at both apical and basal positions. In contrast, neurocognitive limiting factors were identified in 14 out of 32 subjects. Early sentence recognition scores were predictive of long-term sentence recognition thresholds in noise such that limiting factors appeared to be of continuous influence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Both peripheral and neurocognitive processing factors affect early sentence recognition after CI activation. Peripheral limiting factors may have been detected le","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"98-110"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting-State Functional Connectivity Predicts Cochlear-Implant Speech Outcomes.","authors":"Jamal Esmaelpoor, Tommy Peng, Beth Jelfs, Darren Mao, Maureen J Shader, Colette M McKay","doi":"10.1097/AUD.0000000000001564","DOIUrl":"10.1097/AUD.0000000000001564","url":null,"abstract":"<p><strong>Objectives: </strong>Cochlear implants (CIs) have revolutionized hearing restoration for individuals with severe or profound hearing loss. However, a substantial and unexplained variability persists in CI outcomes, even when considering subject-specific factors such as age and the duration of deafness. In a pioneering study, we use resting-state functional near-infrared spectroscopy to predict speech-understanding outcomes before and after CI implantation. Our hypothesis centers on resting-state functional connectivity (FC) reflecting brain plasticity post-hearing loss and implantation, specifically targeting the average clustering coefficient in resting FC networks to capture variation among CI users.</p><p><strong>Design: </strong>Twenty-three CI candidates participated in this study. Resting-state functional near-infrared spectroscopy data were collected preimplantation and at 1 month, 3 months, and 1 year postimplantation. Speech understanding performance was assessed using consonant-nucleus-consonant words in quiet and Bamford-Kowal-Bench sentences in noise 1-year postimplantation. Resting-state FC networks were constructed using regularized partial correlation, and the average clustering coefficient was measured in the signed weighted networks as a predictive measure for implantation outcomes.</p><p><strong>Results: </strong>Our findings demonstrate a significant correlation between the average clustering coefficient in resting-state functional networks and speech understanding outcomes, both pre- and postimplantation.</p><p><strong>Conclusions: </strong>This approach uses an easily deployable resting-state functional brain imaging metric to predict speech-understanding outcomes in implant recipients. The results indicate that the average clustering coefficient, both pre- and postimplantation, correlates with speech understanding outcomes.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":"46 1","pages":"128-138"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Asymmetric Hearing Loss on Peripheral and Central Auditory Processing Abilities in Patients With Vestibular Schwannoma.","authors":"Veronika Svobodová, Oliver Profant, Josef Syka, Diana Tóthová, Zbyněk Bureš","doi":"10.1097/AUD.0000000000001555","DOIUrl":"10.1097/AUD.0000000000001555","url":null,"abstract":"<p><strong>Objectives: </strong>Asymmetric or unilateral hearing loss (AHL) may cause irreversible changes in the processing of acoustic signals in the auditory system. We aim to provide a comprehensive view of the auditory processing abilities for subjects with acquired AHL, and to examine the influence of AHL on speech perception under difficult conditions, and on auditory temporal and intensity processing.</p><p><strong>Design: </strong>We examined peripheral and central auditory functions for 25 subjects with AHL resulting from vestibular schwannoma, and compared them to those from 24 normal-hearing controls that were matched with the AHL subjects in mean age and hearing thresholds in the healthy ear. Besides the basic hearing threshold assessment, the tests comprised the detection of tones and gaps in a continuous noise, comprehension of speech in babble noise, binaural interactions, difference limen of intensity, and detection of frequency modulation. For the AHL subjects, the selected tests were performed separately for the healthy and diseased ear.</p><p><strong>Results: </strong>We observed that binaural speech comprehension, gap detection, and frequency modulation detection abilities were dominated by the healthy ear and were comparable for both groups. The AHL subjects were less sensitive to interaural delays, however, they exhibited a higher sensitivity to sound level, as indicated by lower difference limen of intensity and a higher sensitivity to interaural intensity difference. Correlations between the individual test scores indicated that speech comprehension by the AHL subjects was associated with different auditory processing mechanisms than for the control subjects.</p><p><strong>Conclusions: </strong>The data suggest that AHL influences both peripheral and central auditory processing abilities and that speech comprehension under difficult conditions relies on different mechanisms for the AHL subjects than for normal-hearing controls.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"60-70"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Loss and Annual Earnings Over a 20-Year Period: The HUNT Cohort Study.","authors":"Astrid Ytrehus Jørgensen, Bo Engdahl, Bernt Bratsberg, Ingrid Sivesind Mehlum, Howard J Hoffman, Lisa Aarhus","doi":"10.1097/AUD.0000000000001554","DOIUrl":"10.1097/AUD.0000000000001554","url":null,"abstract":"<p><strong>Objectives: </strong>The association between hearing loss and income has only been examined in cross-sectional studies. We aim to study annual increase in earnings over 20 years, comparing people with and without hearing loss.</p><p><strong>Design: </strong>We used data from a population-based hearing study in Norway (The Trøndelag Health Study, 1996-1998), including 14,825 persons (46.2% men, mean age at baseline 30.6 years, age range 20 to 40 years). Hearing loss was defined as the pure-tone average threshold of 0.5 to 4 kHz in the better hearing ear ≥20 dB HL (n = 230). Annual earnings were assessed from 1997 to 2017. Longitudinal analyses were performed with linear mixed models adjusted for age, sex, and education.</p><p><strong>Results: </strong>People without hearing loss at baseline (before age 40) had a greater annual increase in earnings over a 20-year follow-up period compared with people with hearing loss. For people with normal hearing, annual earnings over 20 years increased by 453 Euro (EUR) (95% confidence interval [CI] = 384 to 522) or 13.2% more per year than for people with hearing loss, adjusted for age and sex. The difference in annual earnings over 20 year was greater among women (462 EUR, 95% CI = 376 to 547) than men (424 EUR, 95% CI = 315 to 533), greater among younger than older adults, and greater among lower than higher educated persons. When including adjustment for education in the model, in addition to age and sex, the difference in annual earnings over 20 years between persons with and without hearing loss was reduced (337 EUR, 95% CI = 269 to 405).</p><p><strong>Conclusions: </strong>The results from this large population-based study indicates that people with hearing loss experience lower long-term earnings growth compared with people with normal hearing. The findings highlight the need for increased interventions in the workplace for people with hearing loss.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"121-127"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Relationship Between Hearing Health Beliefs and Social Determinants of Health in Black Adults.","authors":"Charity T Lewis, Julia Toman, Victoria A Sanchez, Jaime Corvin, Michelle L Arnold","doi":"10.1097/AUD.0000000000001562","DOIUrl":"10.1097/AUD.0000000000001562","url":null,"abstract":"<p><strong>Objectives: </strong>Hearing loss is a highly prevalent condition; however, it is widely under-treated, and Black Americans have been found to have significantly lower rates of hearing aid utilization than other ethnic/racial groups. In this exploratory study, we aimed to identify hearing health beliefs among Black adults, guided by the Health Belief Model, with social determinants of health, and examine individual differences in these perspectives.</p><p><strong>Design: </strong>The Hearing Beliefs Questionnaire (HBQ) was administered online to measure constructs of the Health Belief Model among 200 Black adults aged 18 to 75 ( M = 39.14, SD = 14.24). Approximately 13% reported hearing difficulty. In addition, 11 social determinants of health questions were included. Participants were recruited from a university otolaryngology clinic and local Black congregations, meeting inclusion criteria of being 18 or older and Black/African American. Mean scores and SDs for HBQ subscales were calculated. Analysis included analysis of variance and t tests to explore relationships with demographic variables and social determinants of health. Multiple regression analyses predicted HBQ subscale scores from sociodemographic variables.</p><p><strong>Results: </strong>Mean HBQ subscale scores ranged from 3.88 (SD = 2.28) for Perceived Barriers to 6.76 (SD = 1.93) for Perceived Benefits. Positive correlations were observed between Perceived Severity, Perceived Benefits, and Perceived Self-Efficacy scores and participant educational attainment. Lower economic stability was correlated with poorer scores in Perceived Self-Efficacy, Perceived Severity, and Perceived Benefits. Black adults' willingness to purchase a hearing aid was heavily influenced by their Perceived Benefit, Perceived Severity, and Perceived Self-Efficacy scores, with lower scores correlating with unwillingness to purchase devices. Higher frequency of racism/discrimination and financial hardship correlated with increased Perceived Barriers scores for accessing hearing healthcare. In addition, hearing health beliefs between participants with self-reported hearing difficulty and those without trouble only exhibited differences in the Perceived Susceptibility subscale, with those experiencing hearing difficulty having higher scores in this subscale; no other distinctions were identified.</p><p><strong>Conclusions: </strong>The Health Belief Model, used with social determinants of health, revealed associations, and variations, in the hearing health beliefs held by Black adults. The present investigation reveals heterogeneity within this group and pinpoints individuals at higher risk for untreated hearing loss, stemming from their negative perceptions about hearing healthcare. These beliefs are influenced by demographics and social determinants of health, underscoring areas ripe for intervention.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"111-120"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Analysis of Bilateral Cochlear Implants for Children With Severe-to-Profound Sensorineural Hearing Loss in Taiwan.","authors":"Ting-Hsuen Lin, Pei-Hsuan Lin, Te-Yung Fang, Chen-Chi Wu, Pa-Chun Wang, Yu Ko","doi":"10.1097/AUD.0000000000001568","DOIUrl":"10.1097/AUD.0000000000001568","url":null,"abstract":"<p><strong>Objectives: </strong>Cochlear implants are an option for children with sensorineural hearing loss who do not benefit from hearing aids. Although bilateral cochlear implantation (CI) has been shown to enhance hearing performance and quality of life, its cost-effectiveness remains unclear. This study aimed to evaluate the cost-effectiveness of bilateral CI compared with bimodal hearing for children with sensorineural hearing loss in Taiwan from both the perspectives of patients and Taiwan's National Health Insurance Administration (TNHIA).</p><p><strong>Design: </strong>A four-state Markov model was utilized in the study, including \"use the first internal device,\" \"use the second internal device,\" \"use the third internal device,\" and \"death.\" Health utility values were obtained from a local survey of health professionals and then adjusted by a scale to reflect both the negative impact of aging on hearing and the time needed to develop the full benefit of treatment in the earliest years of life. The cost data were derived from a caregiver survey, hospital databases, clinical experts, and the TNHIA. The incremental cost-effectiveness ratio (ICER) was calculated over the lifetime horizon and presented as cost per quality-adjusted life year (QALY) to evaluate the cost-effectiveness of simultaneous bilateral CI, sequential bilateral CI, and bimodal hearing. In addition, one-way sensitivity analyses and probabilistic sensitivity analyses were conducted to investigate the impact of uncertainty and the robustness of the model.</p><p><strong>Results: </strong>The base-case analysis showed that children with bilateral CI gained more QALYs while incurring more costs when compared with those with bimodal hearing. From the TNHIA perspective, compared with bimodal hearing, the ICER of simultaneous bilateral CI was New Taiwan Dollars 232,662 per QALY whereas from the patient perspective, the ICER was New Taiwan Dollars 1,006,965 per QALY. Moreover, simultaneous bilateral CI dominated sequential bilateral CI from both perspectives. Compared with bimodal hearing, the ICER of sequential bilateral CI did not exceed twice the gross domestic product per capita in Taiwan from either perspective. One-way sensitivity analysis demonstrated that the utility gain of bilateral CI compared with bimodal hearing was the most impactful parameter from both perspectives. Probabilistic sensitivity analysis confirmed the robustness of the base-case analysis results.</p><p><strong>Conclusions: </strong>Our findings reveal that bilateral CI was cost-effective when using the threshold of one to three times the 2022 gross domestic product per capita in Taiwan from both the TNHIA and patient perspectives. Future research incorporating cost and effectiveness data from other dimensions is needed to help decision-makers assess the cost-effectiveness of bilateral CI more comprehensively.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"139-149"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Video Ocular Counter-Roll Findings According to Head and Body Tilt Positions in Healthy Subjects.","authors":"Ahsen Kartal Özcan, Sema Satici, Ahmet Alperen Akbulut, Mert Kiliç, Sare Çankaya, Zahra Polat","doi":"10.1097/AUD.0000000000001563","DOIUrl":"10.1097/AUD.0000000000001563","url":null,"abstract":"<p><strong>Objectives: </strong>A vestibulo-ocular reflex called the ocular counter-roll can be used to assess how well the otolith organs are functioning. The video ocular counter-roll (vOCR) test is a recent addition to the videonystagmography test battery that allows for video recording and quantitative ocular counter-roll analysis. The purpose of this study is to investigate potential discrepancies in vOCR measurements obtained from a 30° lateral head tilt in the roll plane versus measurements obtained from a 30° tilt of the head and body.</p><p><strong>Design: </strong>Thirty otologically, and neurologically healthy subjects aged 18 to 30 (M = 23.32 years, SD = 2.66 years; 8 men, 22 women) participated in this study. Pure-tone audiometry, oculomotor tests, and vOCR evaluation were performed for all participants. The vOCR assessment was performed in 2 positions, 30° lateral head tilt, and 30° body tilt position. The degree of static vOCR eye position and vOCR asymmetry in both positions were calculated and compared.</p><p><strong>Results: </strong>There was no statistically significant difference between the vOCR findings obtained in the right and left 30° lateral head tilt ( p = 0.546) and body tilt ( p = 0.114). vOCR asymmetry was determined as median (interquartile range) 0.08 (0.07) in lateral head tilt position and 0.09 (0.06) in body tilt position. The degree of static vOCR (8.75° [1.91]) detected during body tilt was statistically greater than the static vOCR (6.62 [1.69]) detected during head tilt ( p < 0.001). There was no statistically significant difference in terms of ocular counter-roll asymmetry detected between head tilt and body tilt ( p = 0.918).</p><p><strong>Conclusions: </strong>Our study shows a significant difference in the vOCR responses during head tilt and body tilt, a finding that should be considered during clinical evaluation of vestibular function. There was no significant asymmetry between the responses with either head or body tilt.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"53-59"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}