[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.

[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.

[Strategies of hearing aids fitting for improving speech recognition in noisy environments]. / Vozmozhnosti uluchsheniya razborchivosti rechi v shume pri slukhoprotezirovanii.

THE AIM OF THE STUDY: To assess speech recognition in users of mono- and binaural hearing aids (HA) with dynamic environment control system (DECS). MATERIAL AND METHODS: 25 HA users with symmetrical bilateral moderate to severe sensorineural hearing loss and 10 individuals with normal hearing underwent speech audiometry in a free sound field by listening to an adaptive Russian matrix sentence test with a background noise. The testing was conducted for hearing impaired patients with one and two HA. The Speech Recognition Thresholds in noise (SRTN) using HA with DESC and using HA without DESC were compared. The dichotic digits test and the rapidly alternating speech perception test were performed to evaluate the central auditory system function. RESULTS: The SRTN in normal hearing listeners was -16.4±1.9 dB SNR. In the case of monaural using HA without DESC the SRTN was -2.5±4.4 dB SNR, using HA with DESC it was -5.8±4.0 dB SNR; in the case of using binaural HAs it was -6.3±3.8 dB SNR and -9.9±3.1 dB SNR accordingly. CONCLUSIONS: HAs with Dynamic Environment Control System are highly effective for speech perception in noisy environments. Binaural HA use is more effective than monaural HA use regardless of HA model. Speech recognition in noisy environments in cases of binaural HA use correlates significantly with results of tests assessing the central auditory system function.

[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.

[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.

[Asymmetric sensorineural hearing impairment in the adult population]. / Asimmetrichnaia sensonevral'naia tugoukhost' vo vzrosloi populiatsii.

The relevance of the problem of a sensorineural hearing loss (ASNL) arises from the necessity of the special approaches to the diagnostics of this condition, the complications accompanying this pathology, and the difficulties encountered in the implementation of the methods designed for hearing rehabilitation of such patients. The objective of the present study was to estimate the prevalence of ASHL among the adult population. The sensorineural impairment of hearing was diagnosed in a total of 2456 (72%) examined patients presenting with hearing loss. To determine the presence of asymmetry of sensorineural hearing loss, we employed three counting techniques allowing (1) to calculate the difference between the average hearing thresholds at four frequencies within the range from 0.5 to 4 kHz (the difference was found to be 15 dB or more in 17% of the patients), (2) to calculate the difference between the degrees of hearing loss in the right and left ears (the difference was documented in 47% of the patients), (3) to calculate the difference between the hearing thresholds at least at a single frequency within the range from 0.125 to 8 kHz (he difference was found to be 15 dB or more in 71% of the patients). When using the third method to characterize asymmetry of hearing impairment, it was identified in most patients (53%) at one or two frequencies. Moreover, there was a large number of the patients (13%) with asymmetry apparent over the entire frequency range. A high degree of threshold asymmetry (in excess of 40 dB) was more often noted in the mid-frequency range. In the majority of the patients, the asymmetry manifested itself as the different degree of bilateral sensorineural hearing impairment (51%) or unilateral sensorineural hearing loss with the normal hearing ability preserved in the contralateral ear (35%). The results of the present study give evidence of the necessity of developing a reliable method for the identification of clinically significant ACNL.

[The role of mono- and binaural hearing aid in the rehabilitation of the adult patients presenting with hearing impairment]. / Mono- i binaural'noe slukhoprotezirovanie v reabilitatsii vzroslykh patsientov s tugoukhost'iu.

The objective of the present study was to compare the effectiveness of mono- and binaural hearing aids in the rehabilitation of the adult patients of different age presenting with chronic symmetric hearing loss (CSHL). A total of 263 subjects at the age from 50 to 88 years complaining of moderate to severe (grade I-IV) chronic symmetric hearing impairment were available for the examination. Following the ENT examination with the application of pure tone audiometry and impedancometry, the participants of the study were supplied with the individually fitted digital behind-the-ear hearing instruments and underwent speech audiometry in the free sound field. The intelligibility of polysyllabic words in the calm and noisy environment was evaluated. A significant deterioration of the intelligibility was documented both under the quiet and noisy conditions. Its severity increased with the patients' age and the degree of hearing impairment. The comparison of the results of speech audiometry in the patients using either a single or two hearing aids gave evidence that binaural hearing aids were more efficient than monoaural ones in 86% of the patients. Re-examination of the same patients one year after the completion of the first study has demonstrated that 59% of them became permanent users of the hearing aids with 47% of them making regular use of simultaneously two hearing aids. It is concluded that speech audiometry in the free sound field can be recommended as a highly informative method that allows to substantiate the reasonable choice between the mono- and binaural hearing aids for the adult patients presenting with hearing impairment.

[The patulous Eustachian tube syndrome: the current state-of-the-art and an original clinical observation. Second communication]. / Sindrom ziiaiushchei slukhovoi truby: sovremennoe sostoianie problemy i sobstvennye klinicheskie nabliudeniia. Soobshchenie 2.

The choice of the treatment strategy for the patients presenting with the patulous Eustachian tube syndrome constitutes a serious challenge for an otorhinolaryngologist. Despite the considerable progress achieved during the past years in the development of modern pharmacotherapy and functional endoscopic surgery, the specialists often encounter difficulties in the management of the patients suffering from this disease. The present article (continuing the previous communication) contains information concerning the historical and modern approaches to the treatment of the patients with the patulous Eustachian tube syndrome. The authors describe the conservative and surgical methods employed for the treatment of this condition and the approaches to the choice of the treatment strategies depending on the etiology, pathogenesis, and severity of the disorder being considered, its duration, and the character of the morphological changes identified during the diagnostic procedures. The authors emphasize the importance of the wait-and-see strategy for the treatment of the patients presenting with the patulous Eustachian tube syndrome. In conclusion, they present the concrete results of four original observations of such patients.

[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.

[The patulous Eustachian tube syndrome: the current state of the problem and our own clinical observation. Part 1]. / Sindrom ziiaiushchei slukhovoi truby: sovremennoe sostoianie problemy i sobstvennye klinicheskie nabliudeniia. Soobshchenie 1.

The patulous Eustachian tube syndrome was described more than 150 years ago, but up to the present time some of its aspects continue to be a challenge for both fundamental and clinical medicine. Certain issues of etiology and pathogenesis of this condition have until recently remained unclear which probably accounts for the failure of choosing the adequate methods for its medical correction. Despite the seemingly broad spectrum of the modern tools for the purpose including first and foremost the endoscopic and radiological techniques, verification of the patulous Eustachian tube may encounter difficulties for the specialists. In connection with this, we have undertaken to summarize the views and opinions as regards the syndrome of interest available in the relevant world literature. In the first part of this communication, the authors discuss the modern concepts of etiology and pathogenesis of the patulous Eustachian tube syndrome with special reference to its clinical manifestations and methods of diagnostics.

[The effectiveness of hearing aids in elderly people].

The analysis of factors which influence on the hearing aid efficacy in elderly with presbycusis is presented in the article. 125 patients from 60 to 90 years old with moderate to severe hearing loss, hearing aid users, were examined. The audiology examination included standard methods as well as tests evaluating central auditory pathways processing. According to the results of speech audiometry in free field low efficacy of hearing aid is revealed in 21 % patients. The main factor that decreases hearing aid benefit is the presence of central auditory processing disorders, the additional one is poor technical characteristics of a hearing aid. To increase hearing aid benefit in elderly the correction of central auditory processing disorders, rational hearing aid fitting according to individual features of auditory system and help in adaptation to hearing aid using are required.

[The speech audiometry using the matrix sentence test]. / Rechevaya audiometriya s ispol'zovaniem matriksnogo frazovogo testa.

The matrix sentence test in which the five-word semantically unpredictable sentences presented under the background noise conditions are used as the speech material was designed and validated for many languages. The objective of the present study was to evaluate the Russian version of the matrix sentence test (RuMatrix test) in the listeners of different ages with normal hearing. At the first stage of the study, 35 listeners at the age from 18 to 33 year were examined. The results of the estimation of the training effect dictated the necessity of conducting two training tracks before carrying out the RuMatrix test proper. The signal-to-noise ratio at which 50% speech recognition (SRT50) was obtained was found to be -8.8±0.8 dB SNR. A significant effect of exposure to the background noise was demonstrated: the noise level of 80 and 75 Db SPL led to a considerably lower intelligibility than the noise levels in the range from 45 to 70 dB SPL; in the subsequent studies, the noise level of 65 dB SPL was used. The high test-retest reliability of the RuMatrix test was proved. At the second stage of the study, 20 young (20-40 year old) listeners and 20 aged (62-74 year old) ones were examined. The mean SRT50 in the aged patients was found to be -6.9±1.1 dB SNR which was much worse than the mean STR50 in the young subjects (-8.7±0.9 dB SNR). It is concluded that, bearing in mind the excellent comparability of the results of the RUMat rix test across different languages, it can be used as a universal tool in international research projects.

[Intrauterine infections as a risk factor of the development of sensorineural impairment of hearing ].

Intrauterine infections are a crucial pathogenic factor exerting an appreciable influence on the development of the fetus. They can provoke intrauterine death, cause multiple lesions in the organs and tissues as well as long-term complications that manifest themselves at the later stages of the growth and development of the child. One of such complications is the sensorineural loss of hearing. The importance of hearing impairment arises from the high prevalence of tis condition and frequent incapacitation it causes in the patients. The present publication is focused on various mechanisms underlying the development of hearing impairment depending on the primary infection. Special attention is given to the methods of diagnostics and treatment of intrauterine infections.

[Speech intelligibility in elderly hearing impaired people].

The results of studying the features of auditory perception of speech stimuli in aged patients with hearing loss are presented in the article. 145 patients with moderate to severe sensorineural hearing loss from 52 to 90 years old underwent the tonal threshold audiometry and the tests battery to evaluate central auditory pathways functioning: the gap detection test, frequency difference limens, masking level difference, dichotic digits test. After analyzing speech discrimination scores of monosyllable words in quiet and in noise significantly worse results of all listeners in comparison with listeners with normal hearing are revealed; the deterioration of speech discrimination scores depending on age is noted. The impairment of speech discrimination is maximal when the speech stimuli are presented in background noise. Direct correlation between the deterioration of speech discrimination and the degree of hearing loss, it's duration, the presence of central auditory pathways dysfunction was ascertained.

[The use of speech audiometry in the practice of the geriatric center].

The aim of the study was to evaluate a new test of speech audiometry while examining aged patients. 32 aged listeners from 60 to 88 years old were examined: 20 hearing aid (HA) users and 12 patients with normal hearing thresholds and mild cognitive impairment according to the results of the mini-mental state examination (MMSE). The speech audiometry consisted of the traditional polysyllabic words discrimination test and a new speech test with motor responses (Verbal Tasks and Motor Responses - VTMR); in both tests the signal was presented in background noise (polyphony) in free field. All listeners performed the VTMR test significantly better than the polysyllabic words discrimination test. In the group of hearing impaired patients the mean result in VTMR test was 73,2±29,2 % without HA and 88,6±20,5 % with it, in traditional test - 34,8±20,9 % without HA and 56±18,4 % with it. All patients of the group with normal hearing and mild cognitive impairment performed the VTMR test with 100 % result, their speech discrimination score in traditional test was 88±12 %. In the practice of the geriatric center the use of both the traditional speech audiometry and the new speech test with motor responses seems to be reasonable, that allows examining the auditory function in patients with significant deterioration of speech intelligibility or cognitive impairment.

[The speech audiometry test with the verbal tasks and motor responses]. / Rechevoĭ test s verbal'nymi zadaniiami i motornym otvetom.

The objective of the present study was to estimate the possibility of using the Russian version of the speech audiometry test with the verbal tasks and motor responses (VTMR test) for the examination of the patients of the advanced and senile age suffering from hearing impairment and cognitive disorders. A total of 20 subjects at the age between 60 and 83 years were enrolled in the study. All of them presented with grade II-III bilateral symmetric chronic sensorineural hearing loss associated with mild cognitive disorders. The patients used the hearing aids. Twelve subjects aged 64-88 years presenting with the normal hearing threshold in both ears and mild cognitive impairment (25-27 points in the MMSE test) were included in the study to serve as controls. All the listeners underwent tonal threshold audiometry in combination with speech tests in a free acoustic field (perception of polysyllabic words and VTMR) and filled in the relevant questionnaires (MMSE and HHIE). The results of the study indicate that the VTMR test can be recommended for the evaluation of the effectiveness of hearing aids prescribed to the elderlysubjects and for the study of the auditory function in the patients presenting with cognitive disorders.