Audiology Research <p><strong>Audiology Research</strong> is an international, peer-reviewed, open access Journal designed to be a place where the readers will quickly and clearly find up-to-date and high-quality information related to the Audiology and Neurotology field in a broad sense, including the study, early detection, diagnosis and treatment of all conditions of hearing and balance impairment and audiological and neurotological disorders. Papers ranging from the medical/clinical perspective to the basic and experimental research are encouraged for submission. Papers are welcomed in multiple areas including, but not limited to: Disorders of hearing and balance and neurotology, Balance and Hearing Diagnostic tests, treatments for audiological and balance disorders, Rehabilitative procedures, Genetics, Anatomy and Physiology, Psychoacoustics, Speech and Hearing sciences, Vestibular disorders, Neuroscience and Audiology, Epidemiology, Statistics, Engineering. Audiology Research aims to be the forum for discussion on Audiology and Neurotology for a diverse range of professionals, including researchers, clinicians, technicians, officers from health authorities, healthcare administrators.</p> en-US <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> (Francesca Savio) (Tiziano Taccini) Tue, 07 Jul 2020 12:49:14 +0000 OJS 60 Diagnosis of benign paroxysmal positional vertigo in Emergency Department: Our experience <p>The Benign Paroxysmal Positional Vertigo (BPPV) represents the first cause of peripheral vertigo in populations and it is determined by a displacement of otoconial fragments within the semicircular canals. Following the patient’s head movements, these fragments, moving by inertia, incorrectly stimulate the canals generating vertigo. The BPPV is diagnosable by observing the nystagmus that is generated in the patient following the Dix-Hallpike maneuver used for BPPV diagnosis of vertical semi-circular canal, and, following the supine head yaw test used for lateral semi-circular canal. Correctly identifying the origin of this specific peripheral vertigo, would mean to obtain a faster diagnosis and an immediate resolution of the problem for the patient. In this context, this study aims to identify precise training activities, aimed at the application of specific diagnostic maneuverers for algorithm decisions in support of medical personnel. The evaluations reported in this study refer to the data collected in the Emergency Department of the Cardarelli Hospital of Naples. The results obtained, over a six-month observation period, highlighted the advantages of the proposed procedures in terms of costs, time and number of BPPV diagnoses.</p> Elisabetta Cristiano, Vincenzo Marcelli, Antonio Giannone, Stefania De Luca, Flavia Oliva, Roberto Varriale, Giovanni Motta, Fiorella Paladino, Margherita Benincasa, Marco Perrella, Filippo Ricciardiello Copyright (c) 2020 The Authors Fri, 10 Jul 2020 00:00:00 +0000 Upright head roll test: A new contribution for the diagnosis of lateral semicircular canal benign paroxysmal positional vertigo <p>Diagnosing the affected side in Benign Paroxysmal Positional Vertigo (BPPV) involving the Lateral Semicircular Canal (LSC) is often challenging and uncomfortable in patients with recent onset of vertigo and intense autonomic symptoms. The Minimum Stimulus Strategy (MSS) aims to diagnose side and canal involved by BPPV causing as little discomfort as possible to the patient. The strategy applied for LSC-BPPV includes the evaluation of pseudo-spontaneous nystagmus and oculomotor responses to the Head Pitch Test (HPT) in upright position, to the seated-supine test and to the Head Yaw Test (HYT) while supine. Matching data obtained by these tests enables clinicians to diagnose the affected side in LSC-BPPV. The purpose of this preliminary study is to propose a new diagnostic test for LSC-BPPV complimentary to the HPT, the Upright Head Roll Test (UHRT), to easily determine the affected ear and the involved arm in the sitting position and to evaluate its efficiency. Our results suggest that the UHRT can increase the sensitivity of the MSS without resorting to the HYT, thus reducing patient’s discomfort.</p> Pasquale Malara, Andrea Castellucci, Salvatore Martellucci Copyright (c) 2020 The Authors Tue, 07 Jul 2020 00:00:00 +0000 Analysis of the audiological characteristics and comorbidity in patients with chronic tinnitus <p>Tinnitus is defined as <em>perception of a sound without sound stimulation</em>. This study aims to investigate the correlation between chronic tinnitus and the most significant clinical comorbidities and pharmacological treatments. We recruited 130 consecutive outpatients with a tinnitus for least from three months and 100 subjects without tinnitus. All patients had a full medical and audiological evaluation and all filled in Tinnitus Handicap Inventory questionnaire and Khalfa’s Hyperacusis questionnaire. We also analyzed the qualitative variables: audiometry exam, tinnitus characteristics and psychometric questionnaires. Univariate logistic regression was performed to evaluate the associations between the presence of tinnitus and the presence of comorbidities and drug intake. The statistical analysis provided the following results in the group of patients with tinnitus. We obtained an Odds Ratio statistically significant for the following categories taken into consideration: the presence of anxiety and depression, neurological diseases, headache, temporomandibular joint (TMJ) disorders, intake of levothyroxine and proton-pump inhibitor. In this study, we tried to evaluate the audiological characteristics in the subjects affected by chronic tinnitus in order to find a possible correlation with the comorbidities and any drugs intake. We found a statistically significant correlation between tinnitus and comorbidities like anxiety, depression, TMJ disorders, dysthyroidism, headache and levothyroxine and PPI intake.</p> Silva Pavaci, Federica Tortorella, Alessandra Barbara Fioretti, Anna Maria Angelone, Lino Di Rienzo Businco, Maria Lauriello, Alberto Eibenstein Copyright (c) 2019 Silva Pavaci, Federica Tortorella, Alessandra Barbara Fioretti, Anna Maria Angelone, Lino Di Rienzo Businco, Maria Lauriello, Alberto Eibenstein Thu, 19 Dec 2019 16:02:01 +0000 Computational analysis based on audioprofiles: A new possibility for patient stratification in office-based otology <p>Genetic contribution to progressive hearing loss in adults is underestimated. Established machine learning-based software could offer a rapid supportive tool to stratify patients with progressive hearing loss. A retrospective longitudinal analysis of 141 adult patients presenting with hearing loss was performed. Hearing threshold was measured at least twice 18 months or more apart. Based on the baseline audiogram, hearing thresholds and age were uploaded to AudioGene v4® (Center for Bioinformatics and Computational Biology at The University of Iowa City, IA, USA) to predict the underlying genetic cause of hearing loss and the likely progression of hearing loss. The progression of hearing loss was validated by comparison with the most recent audiogram data of the patients. The most frequently predicted <em>loci</em> were DFNA2B, DFNA9 and DFNA2A. The frequency of <em>loci</em>/genes predicted by AudioGene remains consistent when using the initial or the final audiogram of the patients. In conclusion, machine learning-based software analysis of clinical data might be a useful tool to identify patients at risk for having autosomal dominant hearing loss. With this approach, patients with suspected progressive hearing loss could be subjected to close audiological followup, genetic testing and improved patient counselling.</p> Oren Weininger, Athanasia Warnecke, Anke Lesinski-Schiedat, Thomas Lenarz, Stefan Stolle Copyright (c) 2019 The Author(s) Tue, 05 Nov 2019 12:34:46 +0000 Apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo: Where are the particles? <p>The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV) is attributed to free floating particles in the anterior arm of the lateral semicircular canal – particles attached to the cupula facing the canal or particles attached to the cupula facing the utricle. Zuma e Maia described a new treatment for both canalithiasis of the anterior arm of the horizontal semicircular canal (HC) and cupulolithiasis of the HC. Seventeen patients with apogeotropic HC-BPPV were enrolled and treated with Zuma’s Maneuver. During the repositioning of the particles to the utricule, we observed the direction of the nystagmus evoked in each step of this maneuver in order to know where the otoliths were probably located. Eight patients were diagnosed with canalithiasis of the anterior arm, six patients with cupulolithiasis with the particles facing the canal and three patients with cupulolithiasis with the particles facing the utricle. Our data suggest that we can assume where the otoliths are probably located by observing the pattern of the nystagmus evoked in each step of the Zuma’s Maneuver in patients with apogeotropic HC-BPPV.</p> Bernardo Faria Ramos, Renato Cal, Camila Martins Brock, Pedro Luiz Mangabeira Albernaz, Francisco Zuma e Maia Copyright (c) 2019 The Author(s) Thu, 29 Aug 2019 00:00:00 +0000 Assessment of cochlear trauma and telemetry measures after cochlear implantation: A comparative study between Nucleus® CI512 and CI532 electrode arrays <p>The aim of this study was to compare the new Cochlear™ Nucleus® Profile with Slim Modiolar Electrode (CI532, Cochlear Ltd., Sidney, Australia) with the previous Contour Advance® (CI512) implant through postoperative residual hearing (RH) threshold shift and telemetry measurements as indirect measures of cochlear trauma. We compared 21 patients implanted with the CI532 and 20 patients implanted with the CI512, matching the 2 groups for age and for hearing loss etiology. All subjects received audiological pure tone average (PTA) calculation pre- and postimplant. Electrode impedance was measured, followed by AutoNRT® to measure and evaluate the Neural Response Telemetry (NRT®) thresholds. Telemetry recordings were made intraoperatively, one month after surgery and one month after activation. The NRT-Ratio was calculated to evaluate full <em>scala tympani</em> (ST) insertion. The results showed a higher number of patients with preserved measurable hearing with the CI532 (10/15; P&gt;0.05) compared to the CI512 (5/14; P&lt;0.05). A significant difference in post-operative low frequency PTA was observed between the two groups. There were no significant differences for telemetry measurements and NRTRatio evaluation of full ST insertion (CI512: 81%; CI532: 95%). A significantly higher number of patients who preserved measurable hearing with the CI532, and a significantly higher post-operative low frequency PTA threshold compared with the CI512 confirmed better RH preservation and lower apical cochlear damage with the CI532. There was a high number of full ST insertions for both electrode arrays. Future studies should investigate the audiological effect of implantation in patients with higher levels of RH, correlating the results with the scalar position, to assess any lesser trauma of the CI532.</p> Domenico Cuda, Alessandra Murri Copyright (c) 2019 Domenico Cuda, Alessandra Murri Thu, 11 Jul 2019 15:22:17 +0000 Tinnitus and suicide: An unresolved relation <p>Tinnitus is an auditory phantom sensation which can be a devastating condition for the affected person causing annoyance and discomfort. It may be associated with psychiatric conditions. Patients with highly annoying tinnitus and different comorbidities may have a higher risk of expressing suicidal behaviour and ideation. We aimed to review available reports on the prevalence of suicide and suicidal behaviour with tinnitus patients in order to collate current concepts and to identify possible alarming signs and risk factors. A comprehensive search for appropriate studies listed in PubMed, Ovid and Cochrane databases was conducted using appropriate keyword combinations. We identified 22 publications including original articles, case reports and reviews of which 10 fit our stringent search criteria. Most importantly, from the present studies it appears not feasible to univocally conclude on the co-incidence of tinnitus and suicide. This is due to methodological differences in these approaches, complex interrelations between tinnitus and other psychiatric comorbidities and confounding factors such as the inclusion of patients suffering from post-traumatic stress disorder. More concerted actions involving different medical disciplines are needed to reflect the ethiological heterogeneity of tinnitus and suicide or suicidal behaviour to test for a relationship.</p> Annett Szibor, Antti Mäkitie, Antti A. Aarnisalo Copyright (c) 2019 Annett Szibor, Antti Mäkitie, Antti A. Aarnisalo Fri, 07 Jun 2019 11:17:18 +0000 Effectiveness and efficiency of a dedicated bimodal fitting formula <p>The population of unilateral cochlear implant (CI) users with aidable residual hearing in the contralateral ear is continuously growing. Aiding the contralateral ear with a hearing aid has been shown to provide substantial benefit regarding speech intelligibility in quiet and in noise, sound quality, localization ability and listening effort. In this study, a dedicated hearing aid with the accompanying fitting prescription, tailored to the needs of bimodal listeners was evaluated in nine bimodal CI users. Speech intelligibility scores in noise revealed on-par performance of the dedicated bimodal fitting compared to the clinical standard prescription. 78% of the bimodal CI users preferred the dedicated bimodal fitting over the clinical standard. The minimal subject-specific finetuning effort required during the dedicated bimodal fitting process emphasizes the clinical efficiency.</p> Domenico Cuda, Alessandra Murri, Anna Mainardi, Josef Chalupper Copyright (c) 2019 Domenico Cuda, Alessandra Murri, Anna Mainardi, Josef Chalupper Thu, 09 May 2019 11:47:00 +0000 Vocalization frequency as a prognostic marker of language development following early cochlear implantation <p>Despite their potential significance for later linguistic outcomes, early aspects of vocalization had been seriously undervalued in the past, and thus, minimally investigated until relatively recently. The present article sets out to critically examine existing evidence to: i) ascertain whether vocalization frequency (volubility) posits a plausible marker of cochlear implantation success in infancy, and ii) determine the clinical usefulness of post-implementation vocalization frequency data in predicting later language development. Only recent peer-reviewed articles with substantial impact on vocalization growth during the first year of life, examining sound production characteristics of normally hearing (NH) and hearing impaired infants fitted with cochlear implantation (CI) were mentioned. Recorded differences in linguistic performance among NH and CI infants are typically attributed to auditory deprivation. Infants who have undergone late CI, produce fewer syllables (low volubility) and exhibit late-onset babbling, especially those who received their CIs at the age of 12 months or thereafter. Contrarily, early recipients (before the 12-month of age) exhibit higher volubility (more vocalizations), triggered from CI-initiated auditory feedback. In other words, early CI provides infants with early auditory access to speech sounds, leading to advanced forms of babbling and increased post-implementation vocalization frequency. Current findings suggest vocalization frequency as a plausible criterion of the success of early CI. It is argued that vocalization frequency predicts language development and affects habilitation therapy.</p> Paris Binos, Elena Loizou Copyright (c) 2019 Paris Binos, Elena Loizou Mon, 06 May 2019 11:31:34 +0000 Free-field evoked auditory brainstem responses in cochlear implant users <p>The importance of binaural cues in auditory stream formation and sound source segregation is widely accepted. When treating one ear with a cochlear implant (CI) the peripheral auditory system gets partially replaced and processing delays get added potentially, thus important interaural time differences get altered. However, these effects are not fully understood, leaving a lack of systematic binaural fitting strategies with respect to an optimal binaural fusion. To get new insights into such alterations, we suggest a novel method of free-field auditory brainstem evoked responses (ABRs) analysis in CI users. This method does not bypass the technically induced intrinsic delays of the sound processor while leaving the whole electrode array active, thus the most natural way of stimulation is provided. We compared the ABRs collected of 12 CI users and 12 normal hearing listeners using two different stimuli (chirp, click) at four different intensities each. We analyzed the ABRs using the average of 2000 trials as well as a single trial analysis and found consistent results in the ABRs’ amplitudes and latencies, as well as in single trial relationships between both groups. This method provides a new perspective into the natural CI users’ ABRs and can be useful in future research regarding binaural interaction and fusion.</p> Erik Schebsdat, Manuel C. Kohl, Farah I. Corona-Strauss, Harald Seidler, Daniel J. Strauss Copyright (c) 2018 Erik Schebsdat, Manuel C. Kohl, Farah I. Corona-Strauss, Harald Seidler, Daniel J. Strauss Fri, 07 Dec 2018 09:20:46 +0000