Does sleep quality affect balance? The perspective from the somatosensory, vestibular, and visual systems.

OBJECTIVE: Previous studies have focused on the balance system's involvement in sleep deprivation or disorders. This study investigated how daily routine sleep quality affects the balance system of people without sleep deprivation or diagnosed sleep disorders. METHODS: The study included 45 participants with a BMI score of <25. The PSQI was used to determine sleep quality. The SOT, HS-SOT, and ADT evaluated the vestibular system's functionality. RESULTS: In SOT, condition 3, 4, 5, and 6 composite scores, VIS and VEST composite balance scores, and HS-SOT 5 scores were lower in the HPSQI group. At the same time, there is a statistically significant negative correlation between these scores and PSQI scores. CONCLUSION: Poor sleep quality may be a factor influencing the balance system. Sleep quality affects the visual and vestibular systems rather than the somatosensory system. The population should be made aware of this issue, and clinicians should consider the potential impact of sleep quality when evaluating the balance system.

The Effect of Time-Restricted Feeding on Postural Balance: From Vestibular Perspective.

OBJECTIVE: The aims of the present study were to evaluate postural balance performance of the subjects on the time-restricted feeding (TRF) and reveal the effect of TRF on the vestibular system by comparing the results to those of traditional daily dietary (DD) condition. METHODS: Sixteen adults (3 males, 13 females; mean age 25.4 ± 4) who had experienced at least one month of TRF were included in the study. Sensory Organization Test (SOT) and Head-Shake Sensory Organization Test (HS-SOT) -which evaluate proprioceptive, visual and vestibular systems- were performed on TRF and DD conditions via the Computerized Dynamic Posturography System. RESULTS: Significant differences were obtained between TRF and DD situations in SOT-5 (p=.008), SOT-6 (p=.01), and HS-SOT5 (p =.007) conditions in which the vestibular system dominated. CONCLUSION: We revealed that time-restricted feeding has an effect on postural balance in the absence of proprioceptive and visual systems. This feeding model is a negative stressor that has a substantial effect on the vestibular system, but this impact is minimal once the proprioceptive and visual systems are intact. To best of our knowledge, it is the first study to evaluate postural balance utilizing vestibular parameters in time-restricted feeding.

Speech Perception and Sound Localization Skills in Inner Ear Malformations: Children With Incomplete Partition Type-II.

OBJECTIVE: The present study aimed to evaluate binaural auditory skills in bimodal and bilateral pediatric cochlear implant (CI) users with incomplete partition type-II (IP-II) and to reveal the effect of IP-II on performance by comparing the results to pediatric CI users with normal cochlear morphology. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary referral center. METHODS: Forty-one CI users (mean age 8.8 ± 1.9) were grouped as bimodal (BIM-IP) and bilateral (BIL-IP) users with IP-II; bimodal (BIM-N) and bilateral (BIL-N) users with normal cochlear anatomy. Speech perception in noise and sound localization skills were compared under 2 conditions; binaural (bilateral or bimodal) and monaural (first CI alone). RESULTS: BIM-IP and BIL-IP showed no performance difference in binaural tasks. The BIM-N group showed remarkably poor performance in comparison to the groups of BIL-IP (p = .007), BIM-IP (p < .001), and BIL-N (p = .004) in terms of speech-in-noise skills. In sound localization abilities, similar significant differences were found between the group of BIM-N and the groups of BIL-IP (p = .001), BIM-IP (p < .001), and BIL-N (p = .004). All groups showed statistically significant improvements in binaural condition on both tasks (p < .05). CONCLUSION: We revealed that bilateral and bimodal pediatric CI users with IP-II benefitted from implantation as much as bilateral users with normal anatomy. Differences in residual hearing between groups may explain the poor performance of bimodal users with normal cochlear morphology. To the best of our knowledge, it is the first study to unveil binaural performance characteristics in children diagnosed with a specific inner ear malformation subgroup.

Speech in Noise: Implications of Age, Hearing Loss, and Cognition.

INTRODUCTION: Individuals with hearing loss have reduced hearing sensitivity and may not adequately process the temporal cues in acoustic signals. Cognitive skills that decrease with aging and hearing loss contribute negatively on the ability to understand speech. Hence, they may experience communication problems in noisy environments. The aim of the study was to investigate the effect of sloping high-frequency hearing loss on speech perception in noise and to examine the impact of temporal and cognitive processing in young and middle-age adults. METHODS: Speech in noise (SIN), temporal processing, and cognitive tests were conducted to hearing loss and normal hearing individuals aged 18-59 years. The measurements included the matrix sentence test, binaural temporal fine structure sensitivity (TFS) test, Visual Aural Digit Span (VADS), and Auditory Verbal Learning Test (AVLT). Twenty participants with normal hearing were recruited in the control group, whereas 20 participants with hearing loss at high frequencies were composed of the study group. RESULTS: Hierarchical regression analysis for SIN was performed by entering 3 separate blocks of independent variables. We entered age and hearing loss into the first block, which explained a significant amount of variability in SIN (R2 = 0.72, p < 0.001). Block 2 was comprised of scores from TFS sensitivity test, and this independent variable characterized temporal processing (R2 change = 0.002, p < 0.001). Block 3 was consisted of scores from VADS test and AVLT; these variables characterized cognitive processing and accounted for a good portion of SIN variance (R2 change = 0.04, p < 0.001). The age, hearing loss, and VADS contributed independently in the presence of all independent variables. CONCLUSION: The final model accounted for 76.2% of the variance in SIN. The results suggested that sloping hearing loss, aging, and cognitive decline affected auditory performance, and the poor performance starts from an early age. Additionally, the findings indicated that a more comprehensive approach might be recommended to evaluate the listening skills and identify communication problems.

Pediatric cochlear implant fitting parameters in inner ear malformation: Is it same with normal cochlea?

OBJECTIVES: The aim was to evaluate the cochlear implant (CI) mapping parameters of CI users with inner ear malformation (IEM) and to reveal the changes in parameters over time. METHODS: In total, 118 CI users were included with 127 ears (68-IEM; 59-normal cochlear anatomy) in present retrospective study. The impedance measurements, thresholds levels-THR, most comfortable levels- MCL, pulse width-PW and rate values were analyzed in both IEM and control group at the initial activation, 6th,12th and 24th months postoperatively. RESULTS: There were statistically significant differences in impedance measurements in several time points. And also, there was a remarkable difference in THR & MCL and PW values between IEM and control groups in all time points (p < 0.05). THR & MCL levels and PW values increased significantly between all time periods in both groups (p < 0,008) and values of parameters in IEM-group were higher than those of control group. When comparing rates, statistically significant difference was observed only at the initial activation in both within (p < 0.001) and between groups (p = 0.03). CONCLUSION: Pediatric CI users with IEM need individual changes in fitting parameters. More frequent map sessions should be planned as they require more PW, THR and MCL increase over time. The increase rate differs between IEM subgroups depending on the deviation of malformation from the normal cochlear anatomy. This study is the first to in its attempt to reveal the mapping characteristics and long-term changes in pediatric CI users with different IEM subgroups.

Is Early Cochlear Implant Device Activation Safe for All on-the-Ear and off-the-Ear Sound Processors?

BACKGROUND: Cochlear implantation (CI) is an effective treatment option for patients with severe-to-profound hearing loss. When CI first started, it was recommended to wait until at least 4 weeks after the CI surgery for the initial activation because of possible complications. Advances in the surgical techniques and experiences in fitting have made initial activation possible within 24 h. OBJECTIVES: To compare the complaints and complications after early activation between behind-the-ear (BTE) and off-the-ear (OTE) sound processors and to show the impact of early activation on the electrode impedance values. METHOD: CI surgeries performed between March 2013 and July 2018 were retrospectively analyzed from the database. In total, 294 CI users were included in the present study. The impedance measurements were analyzed postoperatively at the initial activation prior to the stimulation, and 4 weeks after the initial activation in the first-month follow-up visit. A customized questionnaire was administered in the first-month follow-up fitting session to caregivers and/or patients who were using CI at least for 6 months. Medical records were also reviewed to identify any postoperative complications. RESULTS: In the early activation group, impedance values were significantly lower than in the control group (p < 0.05) at first fitting. At the first-month follow-up, no significant difference was found between the groups (p > 0.05). The most common side effects were reported to be edema (6.1%) and pain (5.7%) in the early activation group. In patients with OTE sound processors, the rate of side effects such as skin infection, wound swelling, skin hyperemia, and pain was higher than in patients with BTE sound processors; however, a statistical significance was only observed in wound swelling (p = 0.005). Selecting the appropriate magnet was defined as a problem for the OTE sound processors during the initial activation. CONCLUSION: This study revealed that early activation of CI was clinically safe and feasible in patients with BTE sound processors. When using OTE sound processors, the audiologists should be careful during the activation period and inform patients of possible side effects. The first fitting should be delayed for 4 weeks after CI for OTE sound processors. This current study is the first to report this finding with 5 years of experience in a large cohort.