[Speech intelligibility in adults after the new coronavirus infection (COVID-19)]. / Razborchivost' rechi u vzroslykh patsientov posle novoi koronavirusnoi infektsii (COVID-19).

OBJECTIVE: The research was aimed to assess speech intelligibility in adults after the new coronavirus infection (COVID-19), state of peripheral and central parts of auditory system and cognitive functions. MATERIAL AND METHODS: 26 people complaining about hearing loss, poor speech intelligibility and/or tinnitus after COVID-19 were examined. All the patients underwent the basic audiological assessment before COVID-19. Extended testing in patients after COVID-19 included: pure tone audiometry, impedancemetry, speech audiometry in quiet and noise (evaluation of monosyllabic words intelligibility and the Russian matrix sentence test RuMatrix), the alternating binaural speech test, the dichotic digits test and the Montreal Cognitive Assessment (MoCA). RESULTS: The most significant deviations from the normative values were obtained in the RuMatrix test and the dichotic digits test that may be due to both central auditory processing disorder and memory impairment. Low MoCA scores were obtained in 62% of patients. CONCLUSION: Deterioration of speech intelligibility after COVID-19 was revealed, both in patients with hearing loss and with normal hearing that corresponded to their complaints. It may be caused by central auditory disorder, memory impairment or cognitive status lesion. The correlation found between the results of the RuMatrix test in noise and the severity of the COVID-19 may indicate the impact of the virus on the auditory cortex.

[Clinical protocol: audiological assessment of infants in Russian Federation. Part II]. / Protokol audiologicheskogo obsledovaniya detei pervogo goda zhizni v Rossiiskoi Federatsii. Chast' II.

This is the second part of the previously published clinical protocol of audiological assessment in infants. The goal of the protocol is unification approaches to audiological diagnosis of the infants. The following sections were included in the second part of the protocol: behavioral testing in infants, testing sequence, duration of the examination and necessity in follow-up, hearing assessment in special cases (premature children, children with congenital infections, after meningitis, with external ear abnormalities, single-sided deafness, with hydrocephalus and shunts, with auditory neuropathy spectrum disorder, with mild hearing loss and otitis media with effusion), medical report.

[Clinical protocol: audiological assessment of infants in Russian Federation. Part I]. / Protokol audiologicheskogo obsledovaniya detei pervogo goda zhizni v Rossiiskoi Federatsii. Chast' I.

The clinical protocol of audiological assessment in infants was prepared by the workgroup of Russian pediatric audiologists from different regions. The goal of the protocol is unification approaches to audiological diagnosis of the infants. The protocol has been developed according the evidence based medicine principles, by reviewing current scientific publications on the topic and taking into account the order of providing medical services and other clinical practice guidelines. When direct evidence was not available, both indirect evidence and consensus practice were considered in making recommendations. This guideline is not intended to serve as a standard to dictate precisely how the child should be diagnosed. This guideline is meant to provide the evidence base from which the clinician can make individualized decisions for each patient. The first part of the protocol covers following sections: equipment, staff requirements, timing of the diagnostics, case history and risk factors, preparing the child for the appointment, sedation and general anesthesia, otoscopy, tympanometry and acoustic reflex, otoacoustic emissions, skin preparing, electrode montage, choosing the stimulators, auditory brainstem responses on broadband and narrow-band stimuli, on bone conducted stimuli, auditory steady-state responses, masking, combined correction factors.

[Analysis of hearing aids application in elderly patients.]

The aim of the study is to evaluate the possibility to implement machine learning to create a digital auditory profile for elderly patients and to analyze the hearing aid fitting efficacy depending on involvement of the peripheral and central auditory pathways in a pathological process. Data analysis of 375 people aged 60-93 years is presented. 355 patients with chronic bilateral hearing loss (230 of them used hearing aids) were included in the main group, and 20 normal hearing elderly people were included in the control group. Audiological examination consisted of standard tests (pure tone audiometry, impedancemetry, speech audiometry in quiet) and tests to evaluate the central auditory processing (binaural fusion, dichotic digits, speech audiometry in noise, random gap detection). The Montreal Cognitive Assessment was used to detect cognitive impairment. The hearing aid fitting efficiency was evaluated with COSI questionnaire and speech audiometry in free field. Processing of the results was carried out using Pearson's correlation analysis aimed at creating a polynomial model of a patient's hearing on the basis of the limited test battery. There were close correlations between the state of cognitive functions and age, results of tests to evaluate the central auditory processing, as well as patients' satisfaction of hearing aid. The results of the work indicate the possibility of using computer technologies of data analysis to develop rehabilitation programs for elderly hearing impaired patients.

[Autoimmune hearing loss and a chance of its development in children: literature review and own observations]. / Autoimmunnaya tugoukhost' i veroyatnost' ee formirovaniya v detskom vozraste: obzor literatury i sobstvennye nablyudeniya.

Autoimmune sensorineural hearing loss (AiSNHL) is an uncommon auditory disorder characterized by rapidly progressive bilateral hearing loss and a positive clinical response to treatment with corticosteroids and cytostatics. The prevalence of the disease in the adult population is less than 1% among all cases of subacute and permanent sensorineural hearing loss (precise data are unknown), it is even rarer in children. AiSNHL can be primary (isolated, organ-specific) or secondary (manifestation of another systemic autoimmune disease). The pathogenesis of AiSNHL is based on the proliferation of autoaggressive T cells and the pathological production of autoantibodies to the protein structures of the inner ear, which leads to damage to various parts of the cochlea (possibly also to the retrocochlear parts of the auditory system), less frequently to the vestibular labyrinth. Pathologically, the disease is most often represented by cochlear vasculitis with degeneration of the vascular stria, damage to hair cells and spiral ganglion cells, and endolymphatic hydrops. In 50% of cases, the result of autoimmune inflammation may be fibrosis and/or ossification of the cochlea. The most characteristic symptoms of AiSNHL at any age are episodes of sudden progression of hearing loss, fluctuations of hearing thresholds, and bilateral, often asymmetric impairments. The article presents contemporary ideas of the clinical and audiological manifestations of AiSNHL, the possibilities of diagnosing and treating the disease, and highlights the current approaches to (re)habilitation. Along with literature data, two own clinical cases of an extremely rare pediatric AiSNHL are given.

[Auditory neuropathy and prematurity: modern view of the issue (literature review)]. / Auditornaya neiropatiya i nedonoshennost': sovremennyi vzglyad na problemu (obzor literatury).

Auditory neuropathy spectrum disorder (ANSD) is a specific auditory disorder caused by dysfunction of periphery part of the auditory system, in which the function of the outer hair cells is preserved, but the afferent input at the cochlear level suffers due to the pathology of the inner hair cells, neurons of the spiral ganglion and/or the auditory nerve, as well as synaptic contact between them. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, the discrepancy between the hearing level and the electrophysiological data, poor speech perception which may not correlate with the hearing thresholds. ANSD is a multifactorial disease. One of the main risk factors is perinatal pathology and, in particular, prematurity. The possible factors associated with prematurity that provoke the onset of the disease, features of the pathogenesis, clinical and audiological peculiarities of ANSD in premature infants, contemporary approaches to the habilitation of such patients are discussed in the article. The necessity of an individual, patient-oriented approach to the treatment of premature infants with ANSD is substantiated; such an approach should be based both on the genesis of the disorder, taking into account possible points of lesion in the auditory system, and the developmental peculiarities of a premature baby considering the presence of concomitant diseases associated with prematurity. In the article attention is focused on the main directions of habilitation work with such children, including a multidisciplinary approach, regular careful monitoring of the auditory, speech and language skills, intensive psychological and speech therapist support, the choice of an adequate way of intervention and its improvement as necessary.

[The issue of auditory neuropathy: from origins to the present]. / Problema auditornoi (slukhovoi) neiropatii: ot istokov k sovremennosti.

The issue of auditory neuropathy spectrum disorders (ANSD) has been in a focus of specialists attention for a relatively short time, but during this time a huge amount of scientific and practical knowledge about this hearing disorder has been accumulated. ANSD is a specific auditory deficit caused by dysfunction of periphery part of the auditory system, which may affect the inner hair cells, the spiral ganglion neurons and the auditory nerve, as well as the area of synaptic contact between them, while the outer hair cells, as a rule, remain intact. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, electrophysiological data may not correlate with hearing level, the discrepancy between pure tone audiometry and speech discrimination is observed. ANSD prevalence, epidemiology, contemporary views on its etiology, including detailed information on hereditary forms of the disorder and its risk factors are considered in the review. The data on the basic rungs of the ANSD pathogenesis, which underlie the development of various forms of the disorder and mainly determine the rehabilitation approach, are presented. The detailed clinical and audiological characteristics of ANSD are presented; contemporary approach to ANSD diagnosis and rehabilitation, including indications for surgical treatment, are considered.

[Hearing function in children after new coronavirus infection (COVID-19)]. / Sostoyanie slukha u detei, perenesshikh novuyu koronavirusnuyu infektsiyu (COVID-19).

The information about hearing status of patients who have had a COVID-19 is scattered. There are no studies among children population. OBJECTIVE: To evaluate hearing function in children after coronavirus infection. MATERIAL AND METHODS: 87 children aged from 5 months to 17 years who have had a new coronavirus infection were examined in three cities of Russia (St. Petersburg, Novosibirsk and Surgut). Audiologic examination depended on the age and included: otoscopy, TEOAE and DPOAE, ABR, impedansometry, pure tone audiometry, speech audiometry in quiet and noise. Fisher, LittlEARS and PEACH questionnaires were used as well. An evaluation of central auditory processing was performed in case of indications. RESULTS: In 80 children (92%) otoscopy didn't revealed any problems. All children had type A tympanogram. Acoustic reflex was registered in 49 children (56%), wasn't registered on 1-2 frequencies in 27 (31%) children, was registered on only 1 frequency or wasn't registered at all in 11 (13%) children. OAE was present in 83 (95%) children. Audiometric thresholds in all children were within a normal range. Speech intelligibility in quiet and noise in most cases was normal. 7 children with poor speech intelligibility or low Fisher questionnaire results got an extended examination. Binaural fusion speech test, dichotic test, RuMatrix test, gap detection test data showed no signs of central auditory processing disorders. CONCLUSION: There are no cases of hearing loss or central auditory processing disorders were found in children after new coronavirus infection. Due to variety of symptoms and long-term consequences of COVID-19 further hearing examination is required in this group of patients.

[Childhood hearing screening: achievements, difficulties, and possible ways to improve]. / Audiologicheskii skrining v detskom vozraste: dostizheniya, problemy, vozmozhnosti povysheniya effektivnosti.

Hearing impairment is the most common sensory impairment that is seen among adults and children. The frequency of congenital hearing loss is well-known due to implementation of newborn hearing screening. Hearing may change throughout a lifetime due to different factors and, therefore, the number of hearing impaired children increases with age. Introduction of universal newborn hearing screening has enabled earlier detection of hearing loss including unilateral and minimal disorders. Nevertheless, despite significant progress made in this field, there is still a group of hearing impairments that stay undiagnosed timely. Auditory neuropathy spectrum disorders, late-onset hearing loss, low-frequency and minimal hearing impairment are sometimes missed in newborn hearing screening or they manifest later. These types of hearing disorders are covered in detail in this review as well as possible ways of increasing the effectiveness of early diagnosis.

[Psychoacoustic methods in diagnosis of central auditory processing disorders in prematurely born children]. / Psikhoakusticheskie metody v diagnostike narushenii tsentral'noi slukhovoi obrabotki u detei, rodivshikhsya nedonoshennymi.

INTRODUCTION: The presence of numerous perinatal risk factors and comorbid pathology in prematurely born children, even in the absence of peripheral auditory deficit, can lead to disruptions in the processes of higher nervous sound information processing with the formation of central auditory disorders. OBJECTIVE: Audiological assessment of the functional state of auditory system central parts in prematurely born children. MATERIAL AND METHODS: The study involved 54 deeply premature born infants, which were divided into 3 groups depending on age (6-7, 8-9, and 10-11 years), 18 subjects in each group, and 70 healthy, term-born children of the corresponding age. In addition to the traditional audiological examination, all children underwent an assessment of functional state of the central parts of auditory system through a pause detection test (Random Gap Detection Test, RGDT); the perception of fast rhythmic sequences of stimuli, monaural low excess speech testing, binaural interaction test in alternating binaural speech format (ABS ), dichotic presentation of pairs of single digits, single digits and monosyllables, two-digit numerals, Russian matrix phrasal test in noise (RUMatrix) were studied. RESULTS: Prematurely born infants of all age groups were significantly worse compared to control group (p<0.01) while having RGDT, a test for assessing the perception of fast rhythmic sequences of stimuli and dichotic binaural integration tests. Monaural intelligibility of monosyllabic words in silence in children of all three groups did not differ from normal values, but it suffered from contralateral use of noise interference in children aged 6-7. According to the RUMatrix test, legibility of phrases in noise was impaired in 65% of subjects. Test results in the ABS format revealed a significant violation of speech intelligibility (p<0.01) only in children of the younger age group. CONCLUSION: In prematurely born children, there is a dysfunction of the central parts of the auditory system, which is multilevel in nature, partially leveling as children grow older. Moreover, the processes of temporary processing of acoustic information suffer to the greatest extent, not being compensated up to adolescence.

[Application of the matrix sentence test Russian version in children]. / Primenenie russkoiazychnoi versii matriksnogo frazovogo testa u detei.

The Russian version of the matrix sentence test (RUMatrix test) has been shown to be suitable for accurate assessment of speech intelligibility in adults. AIM: To approve the RUMatrix for measurements in children and to evaluate its simplified version (Simplified RUMatrix). MATERIAL AND METHODS: 20 normal-hearing adults and 81 normal-hearing children aged from 5 to 10 years were involved into the study. Both versions of the test were developed by the University of Oldenburg, Germany. The tests contain syntactically homogeneous, semantically unpredictable sentences/phrases presented under the background noise. Each test list is composed of 20 sentences of 5 words for RUMatrix and of 14 speech phrases of 3 words for Simplified RUMatrix. RESULTS: A limitation in the use of the RUMatrix test in children under 10 years of age has been revealed. Evaluation of Simplified RUMatrix test in adults confirmed the perceptual homogeneity of the test list. The results of the RUMatrix test and the Simplified RUMatrix test in children were lower than in adults; they were improving with age and reach adult values by 10 years. One training track of Simplified RUMatrix test should be carried out before the assessment. CONCLUSION: The RUMatrix can be used for children of 10 years and older. The normative data of Simplified RUMatrix both for adults and children of the different ages have been obtained.

[Age-related changes of otoacoustic emission]. / Vozrastnye izmeneniia otoakusticheskoi émissii.

The aim of the study was to assess age-related changes of the transient evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) as well as to evaluate age-related changes of DPOAE suppression in adult subjects with normal hearing and presbycusis. Only women participated in the study: 26 young women with normal hearing (20-31 years old) were included into the first group; the second group consisted of 28 elderly (60-74 years old) with normal hearing; the third group included 28 elderly women with presbycusis (mild-to-moderate hearing loss). Age-related decrease of prevalence and amplitude of OAEs was proved to be significant; no significant differences of these data for left and right ears were revealed. Contralateral suppression of DPOAE was noted more often and was the greatest in young listeners and was presented in all frequency range, meanwhile the suppression was minimal and rarely noted in patients with presbycusis. The DPOAE amplitude enhancement in the contralateral noise condition was recorded in all groups of listeners, more often in aged patients both with normal hearing and hearing loss. These results may indicate age-related changes of medial olivocochlear complex, which take place not only in patients with hearing loss but in normal hearing subjects as well.. The findings were confirmed by the results of acoustic reflex measurements obtained in this study.

[Age-specific dynamics of the auditory function in the extremely premature babies]. / Vozrastnaia dinamika slukhovoi funktsii u detei, rodivshikhsia gluboko nedonoshennymi.

Extremely early premature babies (i.e. those born before the 32nd week of pregnancy) constitute a group at high risk of development of the perceptive forms of hearing impairment represented mostly by chronic sensorineural hearing loss (CSNHL) and hearing neuropathy (HN). The timely diagnostics of these hearing disorders in premature children and, accordingly, their early and adequate rehabilitation provide a basis for the prevention of hearing and speech problems. At the same time, the hearing function in prematurely born babies is known to be highly unstable and can undergo substantial changes with age; these changes are most frequently observed during the early childhood. This paper was designed to report the results of observations of the hearing function dynamics in a cohort of the extremely early premature children. A total of 186 babies were available for the examination. It was shown that 14 (7.5%) of them had hearing problems. They disappeared by the 12th and 24th months of life in 3 children. Three other babies experienced transformation of NH into CSNHL at the age of 12, 14, and 18 months. NH transformed into CSNHL in three children by the age of 12, 24, and 48 months. Five children developed delayed CSNHL by the 10th, 15th, 24th, 28th, and 36th months of the actual life. These findings give evidence that the extremely premature children may experience both the improvement of the hearing function due largely to the processes of maturation in the auditory system and its deterioration or delayed formation of hearing impairment. It is concluded that the extremely early premature children born before the 32nd week of pregnancy should remain under the dynamic audiological observation at least as long as the third or fourth years of life.

[The analysis of the association of the polymorphic variants of the TPMT, COMT, and ABCC3 genes with the development of hearing disorders induced by the cisplatin treatment]. / Analiz assotsiatsii polimorfnykh variantov genov TPMT, COMT i ABCC3 c razvitiem narusheniia slukha, indutsirovannogo priemom tsisplatina.

Cisplatin and its derivatives are widely used chemotherapeutic agents for the treatment of many cancers, including hepatoblastoma, brain tumors, and germ-cell tumors. This therapy contributed to the dramatic increase in the survival rate. However, its use is restricted by the high incidence of irreversible ototoxicity associated with cisplatin application (in more than 60% of the children receiving it). Some studies have reported that genetic variants of TPMT (rs 12201199), COMT (rs4646316), and ABCC3 (rs 1051640) are conferring increased risk of developing cisplatin-induced hearing loss. However, in other studies the results were not replicated. In the present study, we replicated the previous studies based on an independent cohort of Russian patients. SNP genotypes for rs 12201199, rs4646316 and rs 1051640 were determined in DNA samples obtained from 16 patients who developed hearing loss and a group of 34 patients whose hearing was retained. The association between TPMT (rs 12201199), COMT (rs4646316), and ABCC3 (rs 1051640) variants and the hearing loss was not observed in our cohort.

[The application of the screening questionnaires for the diagnostics of the central auditory processing disorders in the pediatric practice]. / Ispol'zovanie skriningovykh anket dlia vyiavleniia tsentral'nykh slukhovykh rasstroistv v pediatricheskoi praktike.

Identification and diagnostics of auditory processing disorders (APD) in the children continues to be a challenge. Screening tools help to decide the need for evaluation. However, none of them are used routinely in Russia, nor are there thus far auditory checklist questionnaires in the Russian language. The aim of his study was to approve Children's Auditory Performance Scale (CHAPS) and Fisher's Auditory Checklist in Russian for the children at the age of 5-10 years. The study included 52 children at the age from 5 to 11 years. All of them were native Russian speakers. Pure tone audiometry, immitancemetry, and the Simplified RuMatrix test were performed for all the children. All of them had normal hearing thresholds, speech and language development, and normal academic achievement at school. The parents filled in the CHAPS and Fisher's Auditory Checklist questionnaires in Russian. The mean value of Fisher's Auditory Checklist was 85.7 ± 9.3, the mean value of CHAPS questionnaire was equal to 0.08 ± 0.26. The results obtained with the use of the Russian language questionnaires are in excellent agreement with the test data yielded by the respective English language versions. It is recommended that the clinical assessment for APD should be performed for children with the result of the Fisher questionnaire less than 67 points and with the result of the CHAPS questionnaire less than -1 point. It is concluded that Fisher's questionnaire was more convenient for the parents to fill in.

[The influence of central auditory processing on the intelligibility of the speech in the patients presenting with hearing impairment]. / Vliianie tsentral'nykh slukhovykh rasstroistv na razborchivost' rechi pri sensonevral'noi tugoukhosti.

The objective of the present study was to evaluate to what degree the function of the central auditory pathways influences the intelligibility of the speech in the patients suffering from the sensorineural loss of hearing (SNLH). The study included a total of 20 patients at the age varying from 31 to 80 years presenting with moderate to moderately severe symmetrical SNLN. All the patients were permanent hearing aid users. They underwent the standard audiological examination including pure-tone threshold and suprathreshold audimetries together with impedancemetry, the evaluation of the functional ability of the central auditory pathways with special reference to temporal resolution and differential frequency sensitivity, binaural integration, and the ability to distinguish a sound stimulus against the background noise. It has been found that the impaired intelligibility of the speech and the decreased efficiency of the hearing aids in the patients presenting with SNLH were attributable to the central auditory pathway disorders detected in 50% of the participants in the study. The strong correlation between the results of detection of the stimulus under conditions of tonal signal interference, the binaural integration test, and intelligibility of the speech in the users of hearing aids was documented.

[Rehabilitation of hearing impaired elderly patients by means of hearing aids with frequency lowering technology.]

The objective of this study was to assess the effectiveness of rehabilitation of hearing impaired elderly patients using hearing aids with frequency lowering technology called Frequency Composition ™. 23 hearing aid users (mean age 64 years) with moderate to severe sensorineural hearing loss were tested. All participants were divided into two groups according to configuration of audiogram: 11 people with averaged slope of 27,9 dB per an octave within frequency range of 1-2 kHz (the 1st group) and 12 people with slope of 24,1 dB at 2-4 kHz (the 2nd group). Average speech tests scores of the 1st group were significantly worse than for the 2nd group (p<0,05 in quiet; p<0,01 in noise). It has been seen that the 1st group had significant better improvement of speech understanding using of Frequency Composition™ than the 2nd group. It has been shown that frequency lowering can improve perception of high frequency sounds and enhance speech intelligibility especially in patients with audiogram slope within frequency range of 1-2 kHz. To effective use of frequency lowering technology a careful selection of patients and adaptation to the new algorithm of amplification are required.