Ear and Hearing最新文献

{"title":"A Retrospective Comparison of Clinical Characteristics of Post-Traumatic and Idiopathic Benign Paroxysmal Positional Vertigo.","authors":"Minheon Kim, Eun Kyung Jeon, Young Joon Seo, Tae Hoon Kong","doi":"10.1097/AUD.0000000000001675","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001675","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the clinical and epidemiological characteristics of post-traumatic benign paroxysmal positional vertigo (BPPV) compared with idiopathic BPPV, with a focus on the impact of trauma severity on clinical outcomes.</p><p><strong>Design: </strong>The authors conducted a retrospective analysis at a regional trauma center, comparing 66 patients with post-traumatic BPPV to 105 patients with idiopathic BPPV. Trauma was defined as cases where patients presented to the regional trauma center following an injury. The severity of trauma was categorized based on whether the trauma team was activated. The diagnostic criteria included positional vertigo and nystagmus, as confirmed through standard positional tests. Patients were categorized based on the severity of their trauma and evaluated for the BPPV subtype, frequency of canalith repositioning maneuvers (CRMs) needed for resolution, and recurrence rates.</p><p><strong>Results: </strong>Patients with post-traumatic BPPV were younger than those with idiopathic BPPV (58.0 ± 15.2 versus 63.0 ± 13.1 yrs; p = 0.024) and showed no significant gender disparity. The most common BPPV subtype in the post-traumatic group was posterior canal BPPV (68.2%), followed by horizontal canal-BPPV (Geo) (22.7%), and horizontal canal-BPPV (Apo) (4.5%). Patients with post-traumatic BPPV required more CRMs for resolution compared with those with idiopathic BPPV (average: 2.0 versus 1.3; p = 0.001); however, the recurrence rates were similar between the two groups. Clinical presentations did not significantly differ between major and minor trauma cases.</p><p><strong>Conclusions: </strong>Post-traumatic BPPV differed from idiopathic BPPV regarding age distribution, CRM frequency, and subtype proportions, but not regarding recurrence rates. Trauma severity did not significantly alter the clinical course of post-traumatic BPPV, suggesting a uniform approach to BPPV management irrespective of trauma severity. However, diagnosing BPPV after major trauma may be delayed; therefore, early consideration of BPPV in the initial stages of trauma assessment is necessary.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045095","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":"Effect of Speech Material and Scoring Method on Psychometric Curves for Cochlear Implant Users and Typical Hearing Listeners.","authors":"Hendrik Christiaan Stronks, Robin van Deurzen, Paula Louisa Jansen, Jeroen Johannes Briaire, Johan Hubertus Maria Frijns","doi":"10.1097/AUD.0000000000001672","DOIUrl":"10.1097/AUD.0000000000001672","url":null,"abstract":"<p><strong>Objectives: </strong>Cochlear implants (CIs) are the primary treatment for severe-to-profound hearing loss. For CI users, speech intelligibility (SI) is often excellent in quiet yet degrades dramatically in background noise. Scientific and clinical testing of the effects of noise on SI is routinely performed with speech-in-noise tests. The sensitivity of these tests to signal to noise ratio depends on the slope of their psychometric curve. This slope is not always known for CI users, and direct comparisons between typical hearing (TH) listeners and CI users are lacking.</p><p><strong>Design: </strong>We present a comparative study of a digit test (DIN), a Matrix sentence test, and an everyday sentence test (LIST) for a group of CI users and TH listeners, with use of word (digit) and sentence (triplet) scoring in the free field. We report descriptive statistics and effect size measures of the psychometric slope and the speech reception threshold (SRT) for each speech test.</p><p><strong>Results: </strong>For CI users, the slopes of the psychometric curve were significantly shallower and SRTs significantly higher than those of TH listeners. The shallowest slope was seen with the Matrix test. However, the small variances of the slope and the SRT resulted in effect size estimates that fell between those of the other two tests. The DIN test was associated with steeply sloped psychometric curves with low variance. The scoring method did not substantially affect slopes and SRTs for the DIN test and LIST sentences, but word scoring resulted in shallow slopes and substantially worse SRTs for CI users.</p><p><strong>Conclusions: </strong>The DIN test stood out in this study as an attractive speech-in-noise test for CI users, with steep slopes and low variance in slopes and SRTs among participants. Digit and keyword scoring appear to be viable options for the DIN test and LIST sentences, respectively, potentially increasing the number of available test items. For the Matrix test, sentence scoring yielded shallow slopes and deteriorated SI, especially for the CI group. We recommend word scoring for the Dutch-Flemish Matrix test.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043143","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":"Motor Competence in School-Aged Children at Risk of Vestibular Loss: An Overview.","authors":"Ruth Van Hecke, Ingeborg Dhooge, Cleo Dhondt, Sarie Martens, Marieke Sucaet, Saartje Vanaudenaerde, Lotte Rombaut, Els De Leenheer, Helen Van Hoecke, Frederik J A Deconinck, Leen Maes","doi":"10.1097/AUD.0000000000001659","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001659","url":null,"abstract":"<p><strong>Objectives: </strong>On the basis of research and clinical experience, our otorhinolaryngology department developed an extensive protocol including auditory, vestibular, and motor assessments for all children at risk of vestibular disorders. The purpose of this study was to present the outcomes of this clinical protocol in a school-aged population and to provide an overview of the main clinical features and the motor competence of the children at risk of vestibular dysfunctions.</p><p><strong>Design: </strong>Data collection for this study took place between October 2017 and October 2021. During this timeframe, all school-aged children (4.0 to 16.9 years old), who were either in follow-up or referred to our otorhinolaryngology department at the Ghent University Hospital because of a risk of vestibular deficits, and who expressed a willingness to participate in the study, were included. Children were deemed at risk if they had (1) vestibular complaints (i.e., vertigo, instability, dizziness), (2) sensorineural hearing loss (with or without cochlear implant[s]), (3) a medical history with ototoxic drugs, (4) inner ear malformations defined by imaging, (5) a head trauma, (6) genetic mutations linked to vestibular loss, or (7) evidence of prior infections that are related to vestibular loss in the literature (e.g., meningitis, congenital cytomegalovirus infection).</p><p><strong>Results: </strong>Among the 117 participants (59 boys; 7.3 ± 3.1 years), four groups could be identified: those with combined vestibular and hearing loss (n = 47), with isolated vestibular loss (n = 5) or hearing loss (n = 33), and those without audiovestibular deficits (n = 32). Group differences revealed diminished fine motor skills, as well as lower balance and total MABC-2 scores in the group with combined vestibular and auditory dysfunctions (p < 0.001), particularly in children with severe bilateral vestibular deficits. Moreover, the majority (38/47; 80.9%) were referred for additional monitoring of their motor functioning and/or for physical therapy.</p><p><strong>Conclusions: </strong>This first large-scale study encompassing school-aged children at risk of vestibular disorders revealed a diverse clinical presentation among them. Considering crucial trends and influential factors, the study emphasized the importance of adopting a comprehensive approach, including auditory, vestibular, and motor tests, for assessing and managing pediatric vestibular concerns, particularly in children with combined vestibular and auditory deficits.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027023","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":"Vestibulo-Ocular Reflex Dysconjugacy Associated With Central Cause of Dizziness.","authors":"Anand K Bery, Ying-Chi Hong, Yu-Hung Kuo, Tzu-Pu Chang","doi":"10.1097/AUD.0000000000001663","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001663","url":null,"abstract":"<p><strong>Objectives: </strong>Most current video head impulse test (vHIT) systems take monocular recordings, which is sufficient to identify a peripheral vestibulopathy. Given central ocular motor abnormalities can cause dysconjugacy between the eyes, binocular vHIT may help further identify central/dangerous lesions. Here, we examined the utility of binocular vHIT to differentiate central from peripheral vestibulopathy.</p><p><strong>Design: </strong>We enrolled three groups: healthy volunteers, consecutive patients with peripheral vestibulopathy, and consecutive patients with central vestibulopathy, respectively. All subjects underwent binocular vHIT, with vestibulo-ocular reflex (VOR) gains of each eye recorded individually. We calculated various measures of VOR gain conjugacy, including intra-class correlation coefficient (ICC), the VOR difference (VORD), and the VOR ratio between the two eyes. The absolute values of VORD (|VORD|) were compared across groups.</p><p><strong>Results: </strong>We enrolled 48 healthy controls, 37 patients with peripheral vestibulopathy, and 17 patients with central vestibulopathy. In rightward impulses, the ICC was 0.89 in controls, 0.98 in the peripheral group, and 0.78 in the central group. In leftward impulses, the ICC was 0.76 in controls, 0.93 in the peripheral group, and 0.71 in the central group. The |VORD| was higher in the central group (mean ± SD: 0.12 ± 0.16) compared to the peripheral group (0.05 ± 0.04, p = 0.02) and healthy controls (0.05 ± 0.03, p = 0.02).</p><p><strong>Conclusions: </strong>Binocular vHIT can measure the VOR gain consistency between two eyes. A finding of high-degree VOR inconsistency should increase clinical suspicion for central vestibulopathy.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053386","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":"Health Service Use in Children With Mild Bilateral and Unilateral Hearing Loss.","authors":"Elizabeth M Fitzpatrick, Eunjung Na, Marie Pigeon, Janet Olds, Lamia Hayawi, Nick Barrowman, Bahar Rafinejad-Farahani, Doug Coyle, Isabelle Gaboury, Andrée Durieux-Smith, Flora Nassrallah, JoAnne Whittingham","doi":"10.1097/AUD.0000000000001661","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001661","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The number of children identified early with mild bilateral and unilateral hearing loss (MUHL) has increased over the past 3 decades due to population-based newborn hearing screening initiatives. Early identification involves additional hearing-related services for these children in the early years. Despite the growing number of children, little information exists regarding their use of health care services. We examined overall health care utilization for this population of children with hearing loss in a Canadian pediatric center as well as the factors associated with audiology and early intervention service utilization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;As part of a longitudinal MUHL research program, we examined health care utilization in a population-based cohort of 182 children with MUHL who were identified in one Canadian pediatric center from 2014 to 2018 and followed up to 6 years. Audiologic characteristics were collected prospectively, and health care utilization data were collected retrospectively through administrative databases. Descriptive statistics were used to summarize health care encounters. We used negative binomial regression models to examine the relationship between several clinical factors including age of diagnosis, degree, and laterality (unilateral/mild bilateral) of hearing loss, use of hearing technology, developmental concerns, and services used in audiology and early intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 182 children were diagnosed at a median age of 4.1 months (interquartile range: 1.9, 55.7) and mean follow-up time was 48.6 (SD: 20.0) months. A total of 9867 hospital encounters were recorded in the medical chart including 2247 audiology, 3429 early intervention, and 701 Ear Nose and Throat service encounters. For audiology services, health care utilization (rate of visits per month of follow-up) was related to whether hearing loss was mild bilateral or unilateral, use of hearing aid(s), progressive hearing loss, developmental concerns, and age of diagnosis. Children with mild bilateral hearing loss had 68% more visits compared with children with unilateral hearing loss. Children with hearing aid(s) had 86%more visits than those without amplification. During the study period, 68.1% of children had at least one early intervention visit. In multivariable regression, after controlling for time followed, earlier age at diagnosis, bilateral hearing loss, use of hearing aid(s), progressive hearing loss, more severe hearing loss, and developmental concerns were all significantly associated with more early intervention service utilization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings provide a comprehensive profile of hearing-related services provided to a population-based cohort of early-identified children with MUHL. Children with mild bilateral loss required more audiology services than those with unilateral hearing loss. Two-thirds of the children with MUHL utilized some ear","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046747","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":"On the Difficulty of Defining Duration of Deafness for Adults With Cochlear Implants.","authors":"Rebecca Kelly, Anna R Tinnemore, Nicole Nguyen, Matthew J Goupell","doi":"10.1097/AUD.0000000000001666","DOIUrl":"10.1097/AUD.0000000000001666","url":null,"abstract":"<p><p>The amount of time that a person with a cochlear implant experiences severe-to-profound hearing loss before implantation is thought to impact the underlying neural survival, health, and function of the auditory system, thus likely being closely related to post-implantation performance in auditory tasks. The reporting of this number in the research literature is ubiquitous. Although it is most commonly called \"duration of deafness,\" our point of view is that the term is imprecise and the calculation of this number can be nontrivial, particularly for cases of adult onset of hearing loss. We provide suggestions on changing the terminology to \"duration of severe-to-profound hearing loss.\" We also propose a method of determining this number through a series of questions that leads a participant/patient through their progression of hearing loss. We encourage research methodology that requires researchers to explicitly report the process used to determine the duration of severe-to-profound hearing loss with the overall goals of (1) improving rigor and reproducibility in cochlear-implant research and (2) improving the translation between research findings and clinical recommendations.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058911","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":"Psychophysical and Electrophysiological Measures of Frequency Modulation Sensitivity: Effects of Age and Interaural Modulator Phase.","authors":"John H Grose, Heidi Martini-Stoica, Monica Folkerts, Stacey Kane, Emily Buss","doi":"10.1097/AUD.0000000000001671","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001671","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The purpose of this study was to measure sensitivity to interaurally in-phase and out-of-phase frequency modulation (FM) using parallel behavioral and electrophysiological approaches. The broader goal was to apply these approaches to the assessment of age-related deficits in temporal fine-structure processing. The hypothesis was that the range of modulation rates over which FM detection is superior for out-of-phase modulation, as well as the magnitude of benefit, diminishes with age due to reduced fidelity of temporal fine-structure processing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Participants were 63 adults with good audiometric hearing for their age divided equally into 3 age groups of young (mean = 23 years), middle-aged (mean = 47 years), and older (mean = 70 years) listeners. FM detection thresholds for stimuli carried by a nominally 500-Hz tone were measured for interaurally in-phase and out-of-phase modulators having rates ranging from 4 to 32 Hz. The rationale for restricting carrier and modulator frequencies to low rates was to focus on the benefit provided by interaurally out-of-phase modulators as a gauge of temporal fine-structure processing. The electrophysiological acoustic change complex (ACC) was also measured in the same participants for a subset of these modulation rates where the depth of modulation was fixed at 3 Hz. The ACC was quantified using an intertrial phase coherence metric.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For in-phase modulation, there was minimal change in FM detection threshold across the range of modulation rates, and no effects of age. For out-of-phase modulation, thresholds were markedly lower for low rates and increased (became poorer) monotonically as rate increased. For the 2 older age groups, thresholds for the 2 modulator phases converged by 32 Hz. Young participants performed consistently better than the participants in the 2 older groups for the out-of-phase configurations. The ACC was most robust for low-rate, out-of-phase modulation and diminished systematically as rate increased in all participants. No ACC was observed for the highest rate of 32 Hz. The older listeners had consistently poorer ACC responses across all rates. Correlations between behavioral and electrophysiological metrics were small, but significant, for rates of 8, 16, and 24 Hz.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The results support the hypothesis of diminishing temporal fine-structure processing as a function of age. For behavioral FM detection, middle-age and older adults had poorer thresholds for out-of-phase FM than young adults, with functions for in- and out-of-phase FM converging at a lower rate. For the ACC test, this was demonstrated by reduced intertrial phase coherences in the older participants. Although there were general similarities between the behavioral and electrophysiological data patterns, some differences were observed, and further study is required to clarify underlying mechanism(s). The","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035977","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":"Effect of Attitudes Toward Hearing Loss and Hearing Aids on the Risk of Device Abandonment Among Older Adults With Hearing Loss Fitted in the Chilean Public Health Sector.","authors":"Eduardo Fuentes-López, Javier Galaz-Mella, Carrie L Nieman, Manuel Luna-Monsalve, Anthony Marcotti","doi":"10.1097/AUD.0000000000001669","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001669","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The World Health Organization estimates that 25% of older adults worldwide have disabling hearing loss. Although hearing aids are the conventional management strategy for this condition, the rate of abandonment of these devices is high. Complete abandonment of the device can expose individuals to the negative consequences of untreated hearing loss. Although previous studies have examined the effect of attitudes on hearing aid abandonment, they have not investigated the time over which abandonment occurs. Consequently, previous evidence has not explored whether attitudes toward hearing loss and hearing aids are associated with the speed (i.e., hazard) at which individuals abandon their hearing aids over time. Our primary objective was to determine the effect of attitudes toward hearing loss and hearing aids on both the risk and timing of hearing aid abandonment. A secondary objective was to assess the potential effect of attitudes toward hearing loss and hearing aids on changes in social participation and withdrawal from social activities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;We conducted a retrospective cohort study involving 355 patients who received hearing aids from a Chilean public hospital. Device abandonment over time was assessed by asking the patients about the specific month of hearing aid abandonment. Attitudes toward hearing loss and hearing aids were measured using the Spanish version of the Attitudes towards Loss of Hearing Questionnaire (S-ALHQ), while changes in participation and withdrawal from social activities were assessed using the Glasgow Benefit Inventory questionnaire. Univariate and multivariate flexible parametric models were developed to estimate the hazard ratio of hearing aid abandonment over time, with attitudes toward hearing loss and hearing aids as the primary predictors. Furthermore, multivariate multinomial regression models were constructed to evaluate the relationship between attitudes and changes or withdrawal from social activities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cumulative incidence of hearing aid abandonment was approximately 21%. The median score on the S-ALHQ was 2.45 points (25th to 75th percentile: 2.05 to 2.77). In the flexible parametric survival models, for each average point increase on the S-ALHQ questionnaire, there was a twofold increase in the risk of hearing aid abandonment over time (Hazard Ratio = 2.09; 95% Confidence Interval = 1.30 to 3.40). In addition, an association was found between attitudes and withdrawal from social activities, with a 5.5-fold increase in the risk ratio for withdrawal from social activities (Relative-Risk Ratio = 5.53; 95% Confidence Interval = 1.49 to 20.56).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;More negative attitudes toward hearing loss and hearing aids were associated with an increased risk of hearing aid abandonment over time, and an increased risk of withdrawal from social activities. Thus, attitudes toward hearing loss and hearing","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053169","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":"Cochlear Implantation Is Associated With Reduced Incidence of Dementia in Severe Hearing Loss.","authors":"Hee Won Seo, Soorack Ryu, Sang-Yoon Han, Seung Hwan Lee, Jae Ho Chung","doi":"10.1097/AUD.0000000000001660","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001660","url":null,"abstract":"<p><strong>Objectives: </strong>Hearing loss is recognized as a potentially modifiable risk factor for dementia in midlife. This study aimed to investigate the association between rehabilitation methods and dementia risk in patients with severe to profound hearing loss.</p><p><strong>Design: </strong>Using the nationwide population data from South Korea, individuals with severe to profound hearing loss were identified. Individuals aged 40 to 79 were then divided into 3 groups according to the type of auditory rehabilitation they received in the period between 2005 and 2010, namely cochlear implant (CI), hearing aid (HA), or no rehabilitation (NR). No hearing loss (NHL) group (with normal hearing) consisted of individuals without hearing loss. Dementia incidence was followed up to 2022.</p><p><strong>Results: </strong>The study involved 649 individuals in the CI group, 35,076 in the HA, 16,494 in the NR, and 1,280,788 in the NHL group. The groups that received auditory rehabilitation (HA and CI groups) had a significantly reduced risk of dementia compared with the NR group, with the CI group showing the most pronounced reduction. The CI group demonstrated a lower risk of dementia than the HA group and had a similar dementia risk to the NHL group.</p><p><strong>Conclusions: </strong>In individuals with severe to profound hearing loss, rates of dementia were lower in CI users than in HA users. Moreover, the risk of dementia in those undergoing CI surgery is comparable to that of individuals with normal hearing.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813046","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 Feasibility in Cochlear Implant Speech Perception Outcomes-Moving Beyond Single Biomarkers for Cochlear Implant Performance Prediction.","authors":"Matthew A Shew, Cole Pavelchek, Andrew Michelson, Amanda Ortmann, Shannon Lefler, Amit Walia, Nedim Durakovic, Alisa Phillips, Ayna Rejepova, Jacques A Herzog, Phillip Payne, Jay F Piccirillo, Craig A Buchman","doi":"10.1097/AUD.0000000000001664","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001664","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Machine learning (ML) is an emerging discipline centered around complex pattern matching and large data-based prediction modeling and can improve precision medicine healthcare. Cochlear implants (CI) are highly effective, however, outcomes vary widely, and accurately predicting speech perception performance outcomes between patients remains a challenge. This study aims to evaluate the ability of ML to predict speech perception performance among CI recipients at 6-month post-implantation using only preoperative variables on one of the largest CI datasets to date, with an emphasis placed on identification of poor performers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;All patients enrolled in the national CI outcome tracking database, HERMES, and the institutional CI registry. Data were split 90/10 training/testing with hyperparameter tuning designed to optimize AUPRC performed during 10-fold cross-validation within 100 iterations. Multiple models were developed to predict final and delta (Δ) in consonant-nucleus-consonant (CNC) words and AzBio sentences at 6-month post-implantation. Two metrics, (1) final performance scores and (2) equally distributed 20th percentile performance ranking were used as primary outcomes. All models were compared with currently used \"gold standard,\" defined as linear or logistic regression models leveraging Lazard features (LF). Final metrics for comparison included mean absolute error (MAE), calibration curves, heat accuracy maps, area under the receiver operating curve (AUROC), and F1 score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1877 patients were assessed through an ML pipeline. (1) XGBoost (XGB) predicted CNC with MAE of 17.4% (95% confidence interval [CI]: 17.34 to 17.53%) and AzBio with MAE of 20.39% (95% CI: 20.28 to 20.50%) and consistently outperformed linear regression with LF (CNC MAE 18.36% [95% CI: 18.25 to 18.47]; AzBio 21.62 [95% CI: 21.49 to 21.74]). Although statistically significant, the 1 to 2% boost of performance is clinically insignificant. (2) Predicting quintiles/20th percentile categories for CI performance, XGB outperformed logistic regression (Log-LF) across all metrics. XGB demonstrated superior calibration compared with Log-LF and provided a larger proportion of predicted probabilities predictions at the extremes (e.g., 0.1 or 0.9). XGB outperformed Log-LF predicting ≤40th percentile for CNC (AUROC: 0.708 versus 0.594; precision: 0.708 versus 0.596; F1 score: 0.708 versus 0.592) and AzBio (AUROC: 0.709 versus 0.572; precision: 0.710 versus 0.572; F1 score: 0.709 versus 0.572). This was consistent for ΔCNC and ΔAzBio. Last, accuracy heat maps demonstrated superior performance of XGB in stratifying sub-phenotypes/categories of CI performance compared with Log-LF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates how ML models can offer superior performance in CI speech perception outcomes prediction modeling compared with current gold standard (Lazard-linear ","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784642","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}