Does Hearing Impairment Impact Spatial Orientation, Navigation, and Rotation Abilities?

OBJECTIVES: Spatial cognition is a perceptual-motor function that pertains to the comprehension and processing of two-dimensional and three-dimensional space. The impairment of any sensory system can have adverse effects on cognitive functioning. The objective of this study is to examine spatial cognition in adults with hearing impairments. METHODS: There were a total of 61 individuals in this study: thirty-six with hearing loss and 25 with normal hearing. The Spatial Orientation Test (SOT), the Mental Rotation test (MR), and the Money's Road Map Test (RMT) were administered to assess participants' spatial learning-orientation, mental imagery-rotation, and spatial navigation abilities. A high number of errors in RMT, high angle difference in SOT and a low score in MR suggest poor spatial abilities. RESULTS: Participants with hearing loss had a greater number of RMT errors and SOT angle difference, but lower MR scores than those with normal hearing (P < .001). Hearing impairment negatively impacted all 3 spatial cognitive assessments. Hearing loss was associated with a 6.9 increase in the number of RMT errors (95% Confidence Interval (CI): 4.8, 9), a 23.6 increase in the SOT angle difference (95% CI: 16, 31.2), and an 8.5 decrease in the MR score (95% CI: -10.8, -6.2). CONCLUSIONS: The study found that individuals with hearing loss exhibited lower performance in various cognitive tasks related to spatial orientation, navigation, spatial learning, mental imagery, and rotation abilities when compared to an age and sex matched control group. In future study, it is imperative to place greater emphasis on hearing loss as a potential detrimental factor in the prediction of spatial cognition impairment.

Evaluation of auditory brainstem implant (ABI) users' auditory behavior in everyday life.

PURPOSE: This study aims to evaluate the everyday listening status of pediatric ABI users using the Turkish ABEL questionnaire. METHODS: The study included 33 parents of children with auditory brainstem implant, and 28 parents of children with cochlear implant were included as a control group. All implant users were between the ages of 4-14. Parents answered the ABEL questionnaire to assess their child's auditory behavior in their daily living environment. In addition, Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scales were used to evaluate speech perception and production. RESULTS: Auditory-aural, auditory awareness and ABEL total score of ABI users were statistically significantly lower than the CI group (p < 0.05). There was no statistically significant difference between the groups in the Conversational/Social skills subgroups. It was found that as the duration of ABI use increased, auditory-verbal, social skills and total scores increased significantly. In addition, correlations were obtained between ABEL total and subscale scores and CAP and SIR scores. CONCLUSIONS: Parents believe that their children adapt nicely to ABI and are aware of environmental sounds. This study reveals the auditory, aural, and social skills of children using ABI through the regards of their parents. This study showed that the ABEL questionnaire, which was used in previous studies to express parental views of children with hearing aids and cochlear implants, can also be used for parents of children using ABI.

Validity and Reliability of Turkish Version of the Auditory Behavior in Everyday Life Questionnaire.

PURPOSE: This study aimed to investigate the validity and reliability of the Turkish version of the Auditory Behavior in Everyday Life (ABEL) questionnaire. METHOD: The ABEL questionnaire was translated into Turkish using the "back-translation" method. The study included 130 parents of children with cochlear implantation, and 126 parents of children with typical hearing were included as a control group. In the study group, there were 62 unilateral and 68 bilateral cochlear implant (CI) users. The age at implantation ranged from 1 to 10 years, as they have substantial auditory skills. The participants' parents completed the ABEL individually, and 73 parents (28, study group; 45, control group) completed the ABEL again for test-retest reliability. Construct validity was tested using confirmatory factor analysis (CFA), and internal consistency was tested using Cronbach's alpha. Spearman's correlation test was used to assess the external validity of the total and all subscales of the ABEL and the Meaningful Auditory Integration Scale (MAIS). Test-retest reliability was measured using the intraclass correlation coefficient. RESULTS: The Cronbach's α values for subscales ranged from .67 to .89, and the value was .93 (excellent) for the overall scale. External validity analyses showed moderate to strong correlations between the total and subscale scores of the ABEL and the MAIS, indicating high external validity. According to the CFA findings, the construct validity of the Turkish version of the ABEL was satisfactory. For the three-factor structure, the goodness-of-fit indices revealed a good fit, and only the normed fit index revealed an acceptable fit. CONCLUSION: The Turkish version of the ABEL is a reliable and valid assessment tool for children with CIs.

Audiological Performance in Children with Inner Ear Malformations Before and After Cochlear Implantation: A Cohort Study of 274 Patients.

BACKGROUND AND OBJECTIVE: Inner ear malformations (IEMs) are common in children with hearing loss. The different types of IEMs form a unique subgroup of cochlear implant (CI) candidates. We aimed to evaluate the auditory perception outcomes of CI in children with different types of IEMs and compare them with CI users without IEMs. METHODS: The study included 274 CI users with and without IEMs as two groups (n = 137, each). Both groups' chronological age at implantation and duration of CI usage was matched (± 8 months). All subjects were evaluated pre-operatively and post-operatively by the Ling's sound test and the auditory perception test battery, which includes the Meaningful Auditory Integration Scale (MAIS), closed-set Pattern Perception Test (PPT) and open-set Sentence Recognition Test (SRT). Besides, children with IEMs were assessed for language development. RESULTS: Progress in the IEMs' group differed according to the type of ear anomaly. CI users with enlarged vestibular aqueduct had the highest scores, while users with common cavity had the lowest. Children with IEMs performed well on the closed-set test while having difficulty with the open-set test. CONCLUSION: Cochlear implantation outcomes are favourable in IEMs' patients with a cochlear nerve visible on magnetic resonance imaging. Our results indicate that it is critical to take the anatomical differences into account during follow-up and rehabilitation programmes. Each CI user should be evaluated according to his or her individual needs.

Auditory Brainstem Response Measurements in Newborns: Which Electrode Placement Is Better?

OBJECTIVE: The objective of this study was to determine the fastest and the most effective auditory brainstem response (ABR) measurement protocol for audiological diagnosis in babies up to three months of age. METHODS: Twenty-two newborns (aged 0 to 63 days) who passed the newborn screening test in at least one ear were evaluated in the study. The ABR were recorded with click stimulus using two different electrode montages (1st montage: ipsilateral mastoid, contralateral mastoid, vertex. 2nd montage: nape of the neck, vertex, cheek). Latencies of waves I, III, V and duration of the test were recorded and analyzed. RESULTS: Wave V latencies from both electrode montages were statistically shortest at the level of 70 dBnHL and longest at the level of 20 dBnHL (p=0.00). When the duration of the test at three different intensity levels were compared between the two electrode montages, only the test durations at 50 dBnHL were significantly different (p=0.017). The test times at 70 dBnHL in the first montage were observed to be significantly different in babies aged 1 to 30 days and aged 31 to 63 days (p=0.005). CONCLUSION: In protocols to evaluate the hearing of pediatric groups, it is very important to complete the ABR, which has significant value in early diagnosis, in a short time and reliably. It is concluded that in terms of practicality, the second montage is more advantageous and comfortable for both audiologists and newborns in single channel ABR systems.

Wideband tympanometry findings in inner ear malformations.

OBJECTIVE: The deficits in the cochlea which is at the one end of the ear sound transfer system, may effect middle ear functions. Wideband typanometry (WBT) is frequently used to evaluate these transfer functions which play a crucial role in setting the impedance matching between the external ear and the cochlea. To this end, the aim of this study was to investigate the ear transfer functions in inner ear malformations via WBT, and to question whether these functions change depending on the types of inner ear malformation. METHODS: This prospective case-control study was conducted in a university hospital. One hundered-fifty-seven ears (aged 3-37 years) under the groups of cochlear hypoplasia, incomplete partition I, incomplete partition II, cochlear aplasia and complete labyrinthine aplasia were evaluated. In the control group, 30 ears with normal hearing were enrolled and WBT was carried out. Tympanometric peak pressure, equivalent middle ear volume, static admittance, tympanogram width, resonance frequency, average wideband tympanometry and absorbance measurements were analyzed. RESULTS: The inner ear malformation groups demonstrated statistically significant differences than the control group and from each other in terms of traditional tympanometric parameters and WBT test parameters (p<0.05). The most remarkable difference was between the group of complete labyrinthine aplasia and the control group, most probably because of complete labyrinthine aplasia's structural effects. However, on some parameters, incomplete partition II and the control group showed similarities. In absorbance measurements, there was significant difference between all patient groups and the control group, especially at high frequencies (p<0.05). The largest difference was between the control group and the group of complete labyrinthine aplasia which has revealed the lowest absorbance values (p<0.05). In averaged-wideband tympanogram analysis, all patient groups obtained a lower amplitude peak than the control group; complete labyrinthine aplasia group had the flattest peaked amplitude, while the incomplete partition II group had a near-normal curve. CONCLUSION: The results of the study revealed the distinctive effects of inner ear malformations in middle ear transfer functions. It is concluded that the absence of inner ear structures causes negative effects on energy absorbance and the other transfer functions of the middle ear. WBT may provide additional information on diagnosis of patients with inner ear malformations.