Cognitive Benefits of Hearing Aids in Elderly Indian Population: A Longitudinal Study.

Age-related hearing loss is common among older individuals and is linked to cognitive impairment and a decrease in overall quality of life. Although hearing aids enhance auditory capabilities, their influence on cognitive performance in the Indian context has not been thoroughly investigated. This study investigates the cognitive benefits of hearing aids in elderly Indian patients with age-related hearing loss. A prospective cohort study was conducted at a tertiary care centre between January 2021 and December 2022. The study included 200 elderly patients who were fitted with behind-the-ear (BTE) or receiver-in-canal (RIC) hearing aids. The assessment of cognitive function was conducted using two standardised tests: the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The assessment of quality of life was conducted using the WHOQOL-OLD questionnaire, while hearing acuity was examined by pure-tone audiometry and speech perception tests. Data were collected at baseline, 6 months, and 18 months. Multiple linear regression analysis identified predictors of cognitive outcomes. There were significant enhancements in MMSE, MoCA, HHIE, and WHOQOL-OLD scores across the 18-month duration (p < 0.001). The pure-tone audiometry thresholds and speech perception scores demonstrated significant improvement (p < 0.001). Regression analysis indicated that baseline cognitive function, hearing ability, and quality of life were significant predictors of cognitive outcomes at 18 months. No severe cognitive impairment or other confounding severe medical conditions were reported. This study revealed that the use of hearing aids has a substantial positive impact on cognitive function, quality of life, and hearing ability in the older Indian population suffering from age-related hearing loss. Timely intervention and the availability of hearing aids are essential for improving cognitive health and overall well-being in this demographic. Future study should look into the consequences and influence of various hearing aid models. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04939-7.

Outcome Evaluation of BAHA Attract System Implantations.

Bone Anchored Hearing Aids (BAHAs) are currently well-utilized for treatment of hearing-impaired patients with unilateral or bilateral mixed and conductive hearing loss as well as patients with single sided deafness. The objective of this study is to evaluate outcome of BAHA Attract system in terms of surgical, functional,audiological and cosmetic results This is a prospective observational study of 15 consecutive patients of single sided deafness (SSD) who qualified for and underwent BAHA Attract surgery at a tertiary care hospital over a duration of two years. Parameters analysed were: (1) Surgery and wound healing, (2) Post-operative functional results (Bern Benefit for Single sided deafness questionnaire (BBSSQ)), (3) audiological results (free field speech in noise audiometry in two situations: with signal from implanted side and from contralateral side), (4) Cosmetic results (introduction of novel Three Points Scoring System (TPSS). Clinico-radiological planning of surgical site for implant is also described.Mean surgical time was 39 minutes and healing was uneventful in 73 % of patients. All patients reported improvement in all ten hearing situations with maximum improvement for sound localization. Significant improvement of speech in noise was seen especially when signal was presented from implanted side. All patient had full score in TPSS for cosmesis except one patient. This was the same patient in whom clinico-radiologically planned site was discarded intraoperatively due to overpneumatised temporal bone.BAHA Attract system is safeand effective solution for single sided deafness with acceptable cosmesis.

A Comparative Analysis of Click ABR and Multi-ASSR in Assessing Infant Hearing: A Cross-Sectional Study.

Introduction: This study investigates the comparative effectiveness of Click Auditory Brainstem Response (Click ABR) and Multiple Auditory Steady-State Response (Multi-ASSR) in identifying hearing impairments in infants. Recognizing auditory issues early is crucial for a child's cognitive and language development, as emphasized by the Joint Committee on Infant Hearing (JCIH) and the American Academy of Audiology (AAA). While Click ABR is widely utilized, Multi-ASSR offers a modern technique for detailed hearing assessment. Methods: A comparative analysis was conducted on 111 infants aged 1-6 months, previously screened for hearing at a tertiary care centre. The study employed both Click ABR and Multi-ASSR to evaluate their respective efficacy in assessing infant hearing. Results: Click ABR detected normal hearing in 87.4% of the infants, slightly higher than Multi-ASSR's 84.7%. A noteworthy finding was the higher incidence of bilateral versus unilateral hearing loss, with Click ABR identifying bilateral loss in 10 infants and unilateral loss in 4, compared to Multi-ASSR, which found bilateral loss in 12 infants and unilateral loss in 5. There was a minor but significant difference in auditory thresholds between the methods, with a mean discrepancy of 1.2 dB and a significant statistical variance (t-value of 15; p < 0.001), indicating variations in sensitivity. Conclusion: Both Click ABR and Multi-ASSR are indispensable tools in paediatric audiology, each with unique advantages. Click ABR excels in efficiency, suitable for rapid assessments and early detection. In contrast, Multi-ASSR offers comprehensive frequency-specific data, facilitating thorough evaluations. Healthcare professionals must grasp these methods' strengths to optimize infant hearing screenings and enhance early intervention strategies, aligning with JCIH and AAA guidelines. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04639-2.

The Impact of Post-Birth Timing on OAE Test Efficacy: An Observational Analysis of Neonatal Hearing Screening.

Identifying auditory impairments early in newborns is essential to prevent developmental delays. Otoacoustic Emissions (OAE) screenings play a critical role in newborn hearing assessments. However, the ideal timing post-birth for these tests remains unclear. This study evaluates the efficacy of OAE screenings within the first five days after birth to determine the most effective timing. An observational study involved 1,013 full-term neonates at a tertiary care centre. These neonates underwent Transient Evoked Otoacoustic Emissions (TEOAE) screenings daily from Day 1 to Day 5, following WHO and JCIH guidelines. The study assessed pass rates, false positives, and false negatives, with follow-up screenings at one and three months for neonates with initial ambiguous results. The study found that screening efficiency significantly increased, with Day 1 pass rates at 8% (81 neonates) and 98% (992 neonates) by Day 5, marking a significant improvement in diagnostic accuracy (p < 0.001). False positive rates dropped from 92% on Day 1 to 2% by Day 5, and false negatives decreased to below 1%. Sensitivity and specificity reached their peak at 98% and 99.5%, respectively, on Day 5. Our study findings advocate for adjusting neonatal hearing screening protocols to include OAE tests on the fifth day post-birth, optimizing clinical efficacy through enhanced diagnostic accuracy and reducing the logistical and emotional burdens on families and healthcare providers. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04700-0.

Echoes Beyond Hearing: Psycho-Social Impacts of OAE Outcomes on Families of Neonates: An Indian Perspective.

The main aim of this study was to explore the psycho-social impacts of Otoacoustic Emissions (OAE) screenings on families. This involved understanding the initial responses of parents to test results, identifying any resulting concerns, and acknowledging the coping mechanisms utilized to handle these unexpectedly encountered difficulties. This retrospective observational study was conducted from January 2021 to December 2022 at a tertiary care facility. An extensive assessment was carried out on 1100 newborns that had undergone the OAE screening. Parental emotional reactions, worries regarding their child's prospects, and employed coping mechanisms were determined using structured questionnaires and interviews. The study aimed to explore the link between socio-economic status and varying levels of post-test anxiety and to study the effect of immediate post-screening counselling. A notable emotional reaction was observed, with 85% of parents, whose neonates were advised for subsequent tests, showing signs of shock and denial. Apprehensions related to the child's growth and societal acceptance were dominant, with 70% parents concerned about potential hurdles. There was a marked correlation between a lower socio-economic status and elevated post-test anxiety. Prompt counselling post-screening resulted in a substantial reduction in parental stress and anxiety levels. While the relevance of OAE testing concerning neonatal health is unequivocal, the psycho-social repercussions it imposes on families are significant. The findings underscore the need for holistic healthcare approaches that not only focus on physiological outcomes but also prioritize the mental well-being of families. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04486-1.

Waardenburg Syndrome Type 2 in Paediatrics: A Case Highlighting Diagnostic Complexities and the Efficacy of Cochlear Implantation.

Waardenburg Syndrome Type 2 (WS2) is a rare hereditary condition with a low prevalence, characterized by abnormalities in both auditory function and pigmentation. We present a case of a 2-year-old female child who exhibited reduced vocalizations, delayed speech development, and distinctive heterochromic irides. Initial auditory assessments revealed bilateral severe to profound hearing loss. Subsequent MRI findings confirmed bilateral aplasia of the posterior semicircular canals, consistent with a diagnosis of Waardenburg syndrome type 2. While standard treatments using bilateral Behind-The-Ear (BTE) power hearing aids yielded only modest improvements, cochlear implantation significantly enhanced auditory perception and speech abilities within 18 months. This report underscores the diagnostic intricacies of WS2 and highlights the profound benefits of cochlear implantation in addressing associated auditory challenges.

New Frontiers in Newborn Hearing Screening: Understanding Auditory Neuropathy and its Predictive Trajectory.

Auditory Neuropathy (AN) poses a substantial challenge in neonatal auditory screenings due to its complex course and potential for delayed onset. Early identification and intervention are important for optimizing developmental outcomes. This study aimed to explore the prevalence, determinants, and temporal progression of AN in neonates, and assess the therapeutic benefit of amplification devices on their communication skills. The study utilized a longitudinal cohort design to analyze a cohort of 200 neonates from a tertiary care center over the duration from January 2021 to December 2022. Auditory evaluations were conducted at specified intervals, utilizing a comprehensive battery of auditory assessments. Statistical analyses, including regression models, were employed to identify associations between various determinants and the progression of AN. The results of the study revealed a significant correlation between low birth weight and familial history with onset of AN. The data also revealed a gradual rise in AN prevalence over the study duration. However, a negative correlation was observed between AN severity and communication skills. The utilization of hearing aids was associated with enhanced communication outcomes. The study highlights the importance of comprehensive auditory screenings in newborns, particularly emphasizing the early detection and intervention of AN. Based on empirical findings, it emerged that amplification devices, particularly hearing aids, have the potential to mitigate the detrimental effects of auditory neuropathy (AN) on communication skills. This study provides a valuable contribution to the academic debate by highlighting the need for strengthening neonatal auditory screening protocols. The findings have profound implications for clinical practices, highlighting the role of early interventions in optimizing developmental prospects for neonates diagnosed with AN. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04386-w.

A study on relationship between Neural Response Telemetry and behavioural Threshold/Comfort levels in children with cochlear implant.

BACKGROUND: Our study was a prospective, non-randomised, single tertiary care centre study involving 50 children below 10 years, all implanted with Nucleus 24™ cochlear implants to find the relationship between intra-operative NRT (Neural Response Telemetry) values and post-operatively behaviourally obtained Threshold (T) and Comfort (C) levels. METHODS: NRT threshold values were obtained intra-operatively by using Custom Sound EP Software V 4.4™ (Cochlear Corporation). At switch-on after three weeks, behavioural T and C levels were measured based on behavioural responses given by patients using Custom Sound Version 4.4 software™ (Cochlear Corporation). NRT values were also measured at switch-on, 2 months, 3 months and 6 months. RESULTS: Intra-operative NRT levels (187.96 ± 12.48) were higher than both T (160.63 ± 22.69) and C (181.21 ± 22.41) levels obtained after 3 weeks. In addition, there was a weak correlation of NRT values with T (P value: 0.05, r = 0.391) and C (P value: 0.05, r = 0.390) levels. CONCLUSION: NRT is a quick and non-invasive tool to confirm cochlear implant integrity. There is a weak correlation of NRT values with both T and C levels and therefore, intra-operative NRT is a weak predictor for setting both T and C levels at switch-on.