A European perspective on auditory processing disorder-current knowledge and future research focus

Current notions of \u201chearing impairment,\u201d as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disorder, defined as \u201cAuditory Processing Disorder\u201d (APD) or \u201cCentral Auditory Processing Disorder\u201d is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimumdiagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diagnostic pathway, and appropriate management are highlighted alongside a perspective on future research focus

The development of the cognitive vestibular function scale in the elderly complaints of imbalance: a study on validity and reliability

Objectives: With a valid and reliable scale, it will make an important contribution to the assessment of cognitive functions such as spatial, spatial-visual, and memory functions, and raise awareness of older people with balance disorders. The purpose of this study is to develop a scale to assess vestibular and cognitive functions in the geriatric population with vestibular disorders and to evaluate its validity and reliability. Methods: The study involved 75 individuals aged 60 years and older who complained of imbalance. In the first phase, scale items on balance, emotional, spatial, spatial-visual, and memory were created using the literature. The item analysis was completed by a pilot application, and 25 scale items were determined for the main application. The item analysis and validity and reliability analyzes were completed, and the scale was given its final form. For the statistical analysis of the data, a principal component analysis was performed for the validity analysis. The Cronbach alpha coefficient was used for the reliability analysis. Descriptive statistics were compiled on the participants' scale scores. Results: The Cronbach's alpha value of the scale was found to be highly reliable at 0.86. Statistically significant values were found between the age variable and the spatial subscales, the spatial-visual subscales, and the Cognitive Vestibular Function Scale with a small positive effect (respectively: r = 0.264; p =  0.022; r = 0.237; p =  0.041; r = 0.231; p =  0.046). The results indicate that the Cognitive Vestibular Function Scale is a valid and reliable measurement tool at a good level in elderly people aged 60 years and older. Conclusion: Cognitive Vestibular Function Scale; was developed to detect cognitive problems related to dizziness/balance. As a result, a preliminary study was conducted to investigate a rapid, easy-to-use, and reliable clinical scale to assess cognitive function in people with balance disorders.Level II Randomized trials Prospective comparative study

Automated Auditory Brainstem Response: A Proposal for an Initial Test For Healthy Newborn Hearing Screening with a Focus on the Test Time

Objective: Some researchers recommend the use of Automated Auditory Brainstem Response as an initial screening test for healthy newborns due to its lower false-positive and referral rates, high specificity, and also its' ability to diagnose auditory neuropathy spectrum disorder combination with Transient Evoked Otoacoustic Emissions test. On the other hand, the test time can be a disadvantage. With technological advancements, a new generation Automated Auditory Brainstem Response has been developed which is faster. The new design of the Automated Auditory Brainstem Response is designed with a coupler that does not contain disposable electrodes is available at an acceptable cost. The aim of this study was comparing the new generation's Automated Auditory Brainstem Response and Transient Evoked Otoacoustic Emissions test by regarding to their test times. The results were then compared with those in previously published literature. Methods: Two hundred and sixty healthy infants were included in the study. The hearing screening of all infants was performed using Transient Evoked Otoacoustic Emissions and Automated Auditory Brainstem Response test devices with new, improved technology. The Ero-ScanTM (Maico, Berlin, Germany) test system was used for the Transient Evoked Otoacoustic Emissions, and the newly designed Maico MB11 BERAphone (Maico-Berlin, Germany) Auditory Brainstem Response screening device with three electrodes in one cap was used for the Automated Auditory Brainstem Response test. Results: Mean age of babies was 60.7+/-51.3 hours, and age range was 4hours-312hours. The test times for the Transient Evoked Otoacoustic Emissions were 13.68+/-9.2s and 14.04+/-9.45, and for the Automated Auditory Brainstem Response, they were 39.15+/-22.2s and 45,25+/-23,9s for the right and left ears respectively. Conclusions: Although the Automated Auditory Brainstem Response test time is statistically longer than the Transient Evoked Otoacoustic Emissions, the amount of time it takes has been significantly shortened by the new technology. This finding enhances the value of the new generation Automated Auditory Brainstem Response technology usage as an initial test for newborn hearing screening.Wo

Electrophysiologic vestibular evaluation in type 2 diabetic and prediabetic patients: Air conduction ocular and cervical vestibular evoked myogenic potentials

Objective: Chronically increased blood glucose levels may affect the vestibular system by damaging cells and neural structures in diabetes mellitus (DM). We aimed to search the effects of neurovascular degeneration on the vestibular system in type 2 DM and prediabetic patients by using air-conducted ocular (oVEMP) and cervical (cVEMP) vestibular evoked myogenic potentials. Design: Prospective study. Study sample: Thirty diabetic, 30 prediabetic patients, and 31 age-and sex-matched controls having no peripheral or central vestibular disease, were enrolled. All participants were evaluated by audiovestibular tests, oVEMP, and cVEMP. Results: In the diabetic group, mean values of both oVEMP and cVEMP p1, n1 latencies were significantly longer compared to the prediabetic group and the control group, whereas latencies were similar in prediabetic and the control groups. Bilateral neural dysfunction was recognized in both tests and lateralization was not seen in VEMP asymmetric ratios. In the diabetic group, prevalence of pathological p1 and n1 latencies in oVEMP were 30.4% and 37.5%, whereas they were 53.7%, 59.3% in cVEMP, respectively. p1 latencies of cVEMP and oVEMP were positively correlated with HbA1c and fasting plasma glucose level in the diabetic group. Conclusion: Subclinical vestibular neuropathy can be a newly defined diabetes-related complication

Can Automated Auditory Brainstem Response Be Used As An Initial Stage Screening Test in Newborn Hearing Screening Programs?

Objectives: Generally, newborns have been tested according to the method recommended by the Joint Committee on Infant Hearing all around the world: a two-stage automated transient evoked oto-acoustic emissions (ATEOAE) program, completed by an automated auditory brainstem response (AABR) for the positive diagnosis of hearing impairment. However, there are still some controversies on this two-stage method. In this study, we used ATEOAE and AABR in combination as an initial stage screening protocol to investigate if we could reduce the disadvantages of routinely performed screening procedure. Materials and Methods: A total of 1,978 neonates were screened for hearing impairment during the study period prospectively. 1,917 of them were tested with both ATEOAE and AABR in the first day of their life. If newborns did not meet pass criteria for any of the tests, both tests were repeated in 10-day period. Results: Out of 1,917 neonates, 202 (10.53%) were failed the initial ATEOAE, and 37 (1.97%) failed the initial AABR. 158 of the 202 neonates that failed the ATEOAE and all neonates that failed AABR was subjected to the second test. Four (2.5%) neonates failed second ATEOAE, and three (1,89%) failed second AABR. All four neonates were referred for further audiologic evaluation, and three of them, whose AABR were negative, were diagnosed as having congenital hearing loss. Conclusion: As a first stage screening method AABR has the lowest false positive rate, referral rate and high specificity. Therefore, we recommend that all universal newborn hearing screening programs should consider revising their protocols to decrease expenses in terms of time and money.Wo

Regional differences of Turkey in risk factors of newborn hearing loss

WOS: 000415777600010PubMed: 29106875Objective: The aim of this study was to discover Turkish regional differences in the risk factors of newborn hearing loss. Method: A multi-centered retrospective design was used. A total of 443 children, registered to the national newborn hearing screening programme, with bilateral hearing loss, from five different regions of Turkey, were evaluated in terms of the types of hearing loss, the degree of hearing loss, the types of risk factors, parental consanguinity, age at diagnosis and age of auditory intervention, respectively. Results: There was no significant difference in the prevalence of hearing loss between regions (chi(2) = 3.210, P = 0.523). Symmetric Sensorineural Hearing Loss (SSHL) was the most common type of HL in all regions (91.8%). Profound HL was the most common degree of HL in all regions (46.2%). There were statistically significant differences between regions in terms of types of HL (chi(2) = 14.151, P = 0.000). As a total, 323 (72.9%) of subjects did not have any risk factors. There were statistically significant differences between regions in terms of the types of risk factors (pre, pen and post-natal) for SSNHL (chi(2) = 16.095, P = 0.000). For all regions, the age of diagnosis was convenient with the JCIH criteria. However the age of hearing aid application was prolonged in some regions. There were statistically significant differences between regions in terms of the age of diagnosis (chi(2) = 93.570, P = 0.000) and the age of auditory intervention (chi(2) = 47.323, P = 0.000). The confounding effects of gender, age of diagnosis, age of hearing aids applications, HL in the family, types of risk factors for HL on SSNHL were detected. Conclusion: To reach the goal of a high quality newborn hearing screening, there is a need to develop an evidence-based standard for follow up guideline. In addition, risk factors should be re-evaluated according to regional differences and all regions should take their own precautions according to their evidence based data. (C) 2017 Elsevier B.V. All rights reserved

Features of unilateral hearing loss detected by newborn hearing screening programme in different regions of Turkey

WOS: 000317998800002PubMed: 23099038Objective: Newborn hearing screening (NHS) works well for babies with bilateral hearing loss. However, for those with unilateral loss, it has yet to be established some standard rules like age of diagnose, risk factors, hearing loss degree. The aim of this study is to identify the demographic characteristics of newborns with unilateral hearing loss to obtain evidence based data in order to see what to be done for children with unilateral hearing loss (UHL). Method: Newborn hearing screening data of 123 babies with unilateral hearing loss, 71 (57.7%) male and 52 (42.3%) female, were investigated retrospectively. Data provided from the archives of six referral tertiary audiology centers from four regions in Turkey. Data, including type of hearing loss; age of diagnosis; prenatal, natal and postnatal risk factors; familial HL and parental consanguinity was analyzed in all regions and each of the Regions 1-4 separately. Result: The difference between data obtained in terms of gender and type of hearing loss was detected as statistically significant (p 0.05). Diagnosis procedure was completed mostly at 3-6 months in Region 4; whereas, in other regions (Regions 1-3), completion of procedure was delayed until 6 months-1 year. Conclusion: This study indicates that the effect of postnatal risk factors, i.e. curable hyperbilirubinemia, congenital infection and intensive care is relatively high on unilateral hearing loss, precautions should be taken regarding their prevention, as well as physicians and other health personnel should be trained in terms of these risks. For early and timely diagnosis, families will be informed about hearing loss and NHS programme; will be supported, including financial support of diagnosis process. By dissemination of the NHS programme to the total of country by high participation rate, risk factors can be determined better and measures can be increased. Additionally, further studies are needed with more comprehensive standard broad data for more evidence based consensus. (c) 2012 Elsevier Ireland Ltd. All rights reserved

Regional differences of Turkey in risk factors of newborn hearing loss

Objective: The aim of this study was to discover Turkish regional differences in the risk factors of newborn hearing loss

Features of unilateral hearing loss detected by newborn hearing screening programme in different regions of Turkey

Objective: Newborn hearing screening (NHS) works well for babies with bilateral hearing loss. However, for those with unilateral loss, it has yet to be established some standard rules like age of diagnose, risk factors, hearing loss degree. The aim of this study is to identify the demographic characteristics of newborns with unilateral hearing loss to obtain evidence based data in order to see what to be done for children with unilateral hearing loss (UHL)