Rehabilitation of Severe to Profound Sensorineural Hearing Loss in Adults: Audiological Outcomes:

The aim of this article is to describe the audiological patterns of 71 adult patients presenting severe to profound sensorineural hearing loss, who were rehabilitated by cochlear implants (CIs) and hearing aids. This is a retrospective study in a university setting, where the clinical records of 71 adult patients were reviewed and processed. Speech intelligibility was evaluated at one aided ear (CI) or at both aided ears (double CI or a combination of CI and hearing aid [HA]). Patients with a bilateral CI or with a bimodal hearing setup (CI and HA) performed better than those with a single CI; data from the phonetic matrices test showed that there was a statistically significant difference among patients aided by a single CI versus binaural setup (double CI or CI + HA). In particular, patients aided by a bilateral CI, or by a CI and HA, showed an improvement in the functional results of the speech tests, compared to patients using a single CI. Binaural hearing (either with a bilateral CI or bimodal) allows an improvement in the functional results at the speech tests, compared to the use of a CI only

Rehabilitation of Severe to Profound Sensorineural Hearing Loss in Adults: Audiological Outcomes

The aim of this article is to describe the audiological patterns of 71 adult patients presenting severe to profound sensorineural hearing loss, who were rehabilitated by cochlear implants (CIs) and hearing aids. This is a retrospective study in a university setting, where the clinical records of 71 adult patients were reviewed and processed. Speech intelligibility was evaluated at one aided ear (CI) or at both aided ears (double CI or a combination of CI and hearing aid [HA]). Patients with a bilateral CI or with a bimodal hearing setup (CI and HA) performed better than those with a single CI; data from the phonetic matrices test showed that there was a statistically significant difference among patients aided by a single CI versus binaural setup (double CI or CI + HA). In particular, patients aided by a bilateral CI, or by a CI and HA, showed an improvement in the functional results of the speech tests, compared to patients using a single CI. Binaural hearing (either with a bilateral CI or bimodal) allows an improvement in the functional results at the speech tests, compared to the use of a CI only

The Bonebridge BCI 602 Active Transcutaneous Bone Conduction Implant in Children: Objective and Subjective Benefits

Background: the Bonebridge hearing implant is an active transcutaneous bone conduction implant suitable for various types of hearing loss. It was first launched in 2012 as the BCI 601, with a newer internal part (BCI 602) released in 2019. With the new size and shape, the BCI 602 can be used in patients previously excluded due to insufficient anatomical conditions, especially in patients with congenital defects of the outer and middle ear. Objectives: the purpose of this study is to evaluate the objective and subjective benefits of the new Bonebridge BCI 602 in children who have hearing impairment due to conductive or mixed hearing loss. Safety and effectiveness of the device was assessed. Methods: the study group included 22 children aged 8–18 years (mean age 14.7 years) who had either conductive or mixed hearing loss. All patients were implanted unilaterally with the new Bonebridge BCI 602 implant. Pure tone audiometry, speech recognition tests (in quiet and noise), and free-field audiometry were performed before and after implantation. Word recognition scores were evaluated using the Demenko and Pruszewicz Polish Monosyllabic Word Test, and speech reception thresholds in noise were assessed using the Polish Sentence Matrix Test. The subjective assessment of benefits was carried outusing the APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire. Results: after implantation of the Bonebridge BCI 602 all patients showed a statistically significant improvement in hearing and speech understanding. The mean word recognition score (WRS) changed from 12.1% before implantation to 87.3% after 6 months. Mean speech reception threshold (SRT) before implantation was +4.79 dB SNR and improved to −1.29 dB SNR after 6 months. All patients showed stable postoperative results. The APHAB questionnaire showed that difficulties in hearing decreased after implantation, with a statistically significant improvement in global score. Pre-operative scores (M = 35.7) were significantly worse than post-operative scores at 6 months (M = 25.7). Conclusions: the present study confirms that the Bonebridge BCI 602 is an innovative and effective solution, especially for patients with conductive and mixed hearing loss due to anatomical ear defects. The Bonebridge BCI 602 system provides valuable and stable audiological and surgical benefits. Subjective assessment also confirms the effectiveness of the BCI 602. The BCI 602 offers the same amplification as the BCI601, but with a smaller size. The smaller dimensions make it an effective treatment option for a wider group of patients, especially children with congenital defects of the outer and middle ear

Skarzynski Tinnitus Scale: validation of a brief and robust tool for assessing tinnitus in a clinical population

Abstract Background Many tinnitus scales are available, but all of them have certain limitations. The aim of the current study was to present a psychometric data of a new brief and reliable questionnaire that could be conveniently used for evaluating tinnitus complaint in adults (either with normal or impaired hearing)—Skarzynski Tinnitus Scale (STS). Methods The study included 125 participants with at least 1 month of tinnitus duration. All participants were asked to complete the STS, Tinnitus and Hearing Survey (THS), Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), and Beck Depression Inventory. Psychometric properties of the new tool were tested using exploratory factor analysis (EFA), Pearson bivariate correlation with other tinnitus questionnaires, Pearson bivariate correlation with pure-tone audiometry, Cronbach’s alpha coefficient, limits of agreement, smallest detectable change, and floor and ceiling effects. Norms for tinnitus severity as measured by the STS are proposed. Results As a whole, the STS has excellent reliability (ICC = 0.94) and good internal consistency (α = 0.91). The results of EFA and content analysis of wording of the items justified the three-factorial structure. The convergent validity was proven by a significant positive correlation with THI, TFI and THS Subscale A scores. Additionally, the authors proposed norms dividing the results into four tinnitus severity grades. Conclusions Statistical analysis shows that STS is a brief but robust tool well-suited to clinical practice. A feature of STS is that it takes into account the impact of tinnitus on the patient’s psychological (emotional, cognitive) and functional domains as well as their ability to cope with tinnitus-related distress

Reference values for psychoacoustic tests on Polish school children 7-10 years old.

BackgroundGood hearing is a fundamental skill that allows children to develop properly, both socially and intellectually. In contrast to defects in inner ear function, however, auditory processing disorders (APDs)-which can affect up to 2-3% of school-children-are not easily identified with basic screening programs and must be diagnosed using special tests. Although such psychoacoustic tests are available, the scores achieved depend highly on the social, cultural, and linguistic characteristics of the population, and norms must be established for each population separately. Reference values are still lacking for the Polish population, especially for children in school-age, so that practitioners must interpret test scores themselves, often intuitively or using potentially biased thresholds from other countries.Materials and methodsWe investigated a sample of 94 Polish schoolchildren with normal hearing, divided into four age groups: from 7 years-olds to 10 years-olds. All children had no speech or language development disorder, learning problem, or symptom of APD. Participants were volunteers who had previously taken part in a large screening study. The group consisted of 56 girls (60%) and 38 boys (40%) with an average age of 8.6 years (SD = 1.1). The test battery included the Duration Pattern Test (DPT), Frequency Pattern Test (FPT), Time-Compressed Speech Test (CST), and Dichotic Digit Test (DDT).ResultsThe scores on all tests increased consistently with age. The difference between each age-group for DPT, CST, and left- and right-ear DDT tests was significant (Kruskal-Wallis test, p-values = 0.002, 0.006, 0.005, 0.020, respectively), but the effect of age on the FPT test was not (p-value = 0.143). The analysis showed a clear and significant separation between a merged group of ages 7 and 8 and another of ages 9 and 10. We, therefore, propose, for each test, separate reference values for these two particular age-groups. Using thresholds based on a 10% quantile, we offer the following reference values for ages 7-8 and 9-10 respectively: DPT, 28.5% and 53.8%; FPT, 18.5% and 27.5%; CST, 68.6% and 77.2%; left-ear DDT, 34.3% and 52.5%; right-ear DDT, 56% and 72.5%.ConclusionThe scores on psychoacoustic tests to diagnose APD differ between cultures and linguistic backgrounds. Clinicians should, therefore, use norms that have been designed for the population most similar to their patients. Here, we report the use of a test battery designed for the Polish language that accounts for various aspects of APD when screening school children. Together with a full methodology of those tests, we provide norms that can be used as cut-offs in clinical diagnosis. Practitioners are invited to use them to obtain more accurate, evidence-based decisions

Cochlear implants in subjects over age 65: Quality of life and audiological outcomes

BACKGROUND Cochlear implants (CIs) have been recognized as a safe and effective means for profound hearing loss rehabilitation in children and adults and recently their use has been extended to subjects over 65 years of age. The aim of this paper was to assess indices related to changes in the quality of life (QoL) in elderly CI recipients. MATERIAL AND METHODS A case-control paradigm was used to assess the effects of CIs on the QoL. Forty-two subjects were assigned to the Case group and 15 subjects to the Control group. All 57 subjects were affected by profound hearing loss and had received a CI. Audiological data were collected from both groups at: (i) 1 month pre-implantation [T1]; (ii) 1 day pre- implantation [T2]; (iii) 30 days post-implantation, with CI used in free field [T3]; and (iv) 12 months post-implantation, with CI used in a free field [T4]. The QoL was assessed via a Glasgow Benefit Inventory (GBI) questionnaire, adapted to otolaryngology. To compare subjects across different ages with varying degrees of speech development, a perception parameter was used from the Speech Perception Categories test developed by Geers and Moog. RESULTS Hearing performance was considerably improved after CI. In relation to the hearing performance at time T1, statistically significant threshold gains were observed in both groups in the T3 and T4 observation windows. At time T4, a threshold gain of 70 dB HL in the Case group and a gain of 84 dB HL in the Control group were observed. With speech therapy rehabilitation, a perception level of 6 was reached by 80.0% of patients in the Case group and by 100% of patients in the Control group. In terms of QoL, both groups showed improved post-CI scores. Statistical differences were observed between the 2 groups, with the Control group outperforming the Case group in all but the social section. CONCLUSIONS Despite age-related changes in auditory system and prolonged hearing deprivation, CIs offer audiological and QoL benefits in the elderly.Background: Cochlear implants (CIs) have been recognized as a safe and effective means for profound hearing loss rehabilitation in children and adults and recently their use has been extended to subjects over 65 years of age. The aim of this paper was to assess indices related to changes in the quality of life (QoL) in elderly CI recipients. Material and Methods: A case-control paradigm was used to assess the effects of CIs on the QoL. Forty-two subjects were assigned to the Case group and 15 subjects to the Control group. All 57 subjects were affected by profound hearing loss and had received a CI. Audiological data were collected from both groups at: (i) 1 month pre-implantation [T1]; (ii) 1 day pre-implantation [T2]; (iii) 30 days post-implantation, with CI used in free field [T3]; and (iv) 12 months post-implantation, with CI used in a free field [T4]. The QoL was assessed via a Glasgow Benefit Inventory (GBI) questionnaire, adapted to otolaryngology. To compare subjects across different ages with varying degrees of speech development, a perception parameter was used from the Speech Perception Categories test developed by Geers and Moog. Results: Hearing performance was considerably improved after CI. In relation to the hearing performance at time T1, statistically significant threshold gains were observed in both groups in the T3 and T4 observation windows. At time T4, a threshold gain of 70 dB HL in the Case group and a gain of 84 dB HL in the Control group were observed. With speech therapy rehabilitation, a perception level of 6 was reached by 80.0% of patients in the Case group and by 100% of patients in the Control group. In terms of QoL, both groups showed improved post-CI scores. Statistical differences were observed between the 2 groups, with the Control group outperforming the Case group in all but the social section. Conclusions: Despite age-related changes in auditory system and prolonged hearing deprivation, CIs offer audiological and QoL benefits in the elderly

Clinically important change in tinnitus sensation after stapedotomy

Abstract Background When measuring the treatment effect in tinnitus with multi-item outcome instruments, it is crucial for both clinical and research purposes to take into consideration clinical importance of the outcome scores. The aim of the present study is to determine minimal important change (MIC) in tinnitus which is clinically meaningful to patients with otosclerosis. Methods The study population was 95 patients with otosclerosis, suffering from tinnitus. They completed the Tinnitus Functional Index before stapedotomy and 3 months after the surgery. The minimal important change was estimated with the Clinical Global Impression Scale as the external criterion (anchor). The mean change method and the receiver operating characteristic (ROC) method were used to determine minimal important change in tinnitus sensation. Results The improvement in tinnitus after stapedotomy was reported by 69.4% of the patients with otosclerosis. Minimal important change in tinnitus was estimated as reduction of 8.8 points in the Tinnitus Functional Index. Conclusions The anchor-based approach using an external criterion (anchor) allows to determine change in tinnitus sensation which is meaningful to patients after stapedotomy. The value of 8.8 points in Tinnitus Functional Index could be used as benchmark of stapedotomy effectiveness in otosclerosis patients suffering from tinnitus. Hearing difficulties comorbid with tinnitus could affect the perception of tinnitus change

Advances in Pediatric and Adult Cochlear Implant and Middle Ear Prostheses

The aim of this special issue, entitled ‘Advances in Pediatric and Adult Cochlear Implant and Middle Ear Prostheses’, is to report the undergoing novel research in the area of ear prostheses, either for the middle or inner ear [...

Novel and De Novo Mutations Extend Association of POU3F4 with Distinct Clinical and Radiological Phenotype of Hearing Loss.

POU3F4 mutations (DFNX2) are the most prevalent among non-syndromic X-linked hearing loss (HL) identified to date. Clinical manifestations of DFNX2 usually comprise congenital HL either sensorineural or mixed, a tendency towards perilymphatic gusher during otologic surgery and temporal bone malformations. The aim of the present study was to screen for POU3F4 mutations in a group of 30 subjects with a suggestive clinical phenotype as well as a group (N = 1671-2018) of unselected hearing loss patients. We also planned to analyze audiological and radiological features in patients with HL caused by POU3F4 defects. The molecular techniques used to detect POU3F4 mutations included whole exome sequencing (WES), Sanger sequencing and real-time polymerase chain reaction. Hearing status was assessed with pure-tone audiometry and auditory brainstem response. Computer tomography scans were evaluated to define the pattern of structural changes in the temporal bones. Six novel (p.Gln27*, p.Glu187*, p.Leu217*, p.Gln275*, p.Gln306*, p.Val324Asp) and two known (p.Ala116fs141*, p.Leu208*) POU3F4 mutations were detected in the studied cohort. All probands with POU3F4 defects suffered from bilateral, prelingual, severe to profound HL. Morphological changes of the temporal bone in these patients presented a similar pattern, including malformations of the internal auditory canal, vestibular aqueduct, modiolus and vestibule. Despite different localization in the POU3F4 gene all mutations severely impair the protein structure affecting at least one functional POU3F4 domain, and results in similar and severe clinical manifestations. Sequencing of the entire POU3F4 gene is recommended in patients with characteristic temporal bone malformations. Results of POU3F4 mutation testing are important not only for a proper genetic counseling, but also for adequate preparation and conduction of a surgical procedure