The relationship between ultra-high frequency thresholds and transient evoked otoacoustic emissions in adults with tinnitus.

Background: The possible role of cochlear function in tinnitus generation is still a matter of debate. To assess the role of outer hair cell dysfunction in tinnitus and its possible relationship with ultra-high frequency (UHF) hearing sensitivity, transient evoked otoacoustic emissions (TEOAE) and UHF hearing thresholds were investigated in normal hearing individuals with and without tinnitus. Methods: Eighteen individuals with tinnitus and 22 without tinnitus participated in this study. TEOAE was recorded with click stimulus at 80 dBpeSPL. UHF pure tone audiometry was performed at 10, 12.5, 16, and 18 kHz. Results: TEOAE was significantly abnormal in 72.2% of the tinnitus, and 18.2% of the control groups (p=0.001). The individuals with tinnitus had significantly poorer UHF hearing sensitivity compared to the control group at 12.5 and 18 kHz (p≤0.048). There was a stronger correlation between increasing UHFs hearing threshold and decreasing SNRs of TEOAEs in the tinnitus group compared to the controls. Conclusion: Our study revealed poorer UHF hearing thresholds and more TEOAE abnormalities in normal hearing individuals with tinnitus compared to the controls. Perhaps the alterations in the basal cochlea, following a decrease in UHF hearing sensitivity, affect OAEs that are originated from more apical cochlear parts in tinnitus ears more than non-tinnitus ears.

Comparison of auditory temporal resolution between monolingual Persian and bilingual Turkish-Persian individuals.

OBJECTIVE: The aims of this study were to prepare a Persian version of the temporal resolution test using the method of Phillips et al (1994) and Stuart and Phillips (1996), and to compare the word-recognition performance in the presence of continuous and interrupted noise as well as the temporal resolution abilities between monolingual (ML) Persian and bilingual (BL) Turkish-Persian young adults. DESIGN: Word-recognition scores (WRSs) were obtained in quiet and in the presence of background competing continuous and interrupted noise at signal-to-noise ratios (SNRs) of -20, -10, 0, and 10 dB. STUDY SAMPLE: Two groups of 33 ML Persian and 36 BL Turkish-Persian volunteers participated. RESULTS: WRSs significantly differed between ML and BL subjects at four sensation levels in the presence of continuous and interrupted noise. However, the difference in the release from masking between ML and BL subjects was not significant at the studied SNRs. CONCLUSIONS: BL Turkish-Persian listeners seem to show poorer performance when responding to Persian words in continuous and interrupted noise. However, bilingualism may not affect auditory temporal resolution ability.

Effects of ageing on speed and temporal resolution of speech stimuli in older adults.

BACKGROUND: According to previous studies, most of the speech recognition disorders in older adults are theresults of deficits in audibility and auditory temporal resolution. In this paper, the effect of ageing on timecompressedspeech and auditory temporal resolution by word recognition in continuous and interrupted noisewas studied. METHODS: A time-compressed speech test (TCST) was conducted on 30 young and 32 older adults with normalhearing thresholds. Lists of monosyllabic words were used at three time compression ratios. Auditory temporalresolution was determined by measuring the monosyllabic word recognition score (WRS), in the presence ofcontinuous and interrupted noise, at three signal-to-noise ratios (S/Ns). RESULTS: There was a significant difference in TCST scores at the three compression ratios within and betweenyoung and older adult none (p< 0.001). Similar results were obtained in WRSs at the three S/Ns in the presenceof interrupted and continuous noise (p< 0.001), and in the degree of auditory temporal resolution(p=0.007). A significant correlation was found between the level of test difficulty of TCST with WRSs in bothyoung (r = 0.549, P=0.002) and older adults (r= 0.531, P=0.003). CONCLUSION: Our results showed that ageing remarkably affects the processing of fast speech stimuli and temporalresolving ability. These results are more supportive of the effect of ageing on speech perception than onloss of hearing.

Assessing Auditory Processing in Children with Listening Difficulties: A Pilot Study.

BACKGROUND: Auditory processing disorders (APD) may be one of the problems experienced by children with listening difficulties (LiD). The combination of auditory behavioural and electrophysiological tests could help to provide a better understanding of the abilities/disabilities of children with LiD. The current study aimed to quantify the auditory processing abilities and function in children with LiD. METHODS: Twenty children, ten with LiD (age = 8.46; SD = 1.39) and ten typically developing (TD) (age = 9.45; SD = 1.57) participated in this study. All children were evaluated with auditory processing tests as well as with attention and phonemic synthesis tasks. Electrophysiological measures were also conducted with click and speech auditory brainstem responses (ABR). RESULTS: Children with LiD performed significantly worse than TD children for most behavioural tasks, indicating shortcomings in functional auditory processing. Moreover, the click-ABR wave I amplitude was smaller, and the speech-ABR waves D and E latencies were longer for the LiD children compared to the results of TD children. No significant difference was found when evaluating neural correlates between groups. CONCLUSIONS: Combining behavioural testing with click-ABR and speech-ABR can highlight functional and neurophysiological deficiencies in children with learning and listening issues, especially at the brainstem level.

Can auditory evoked responses elicited to click and/or verbal sound identify children with or at risk of central auditory processing disorder: A scoping review.

BACKGROUND: (Central) auditory processing disorders, (C)APDs are clinically identified using behavioral tests. However, changes in attention and motivation may easily affect true identification. Although auditory electrophysiological tests, such as Auditory Brainstem Responses (ABR), are independent of most confounding cognitive factors, there is no consensus that click and/or speech-evoked ABR can be used to identify children with or at-risk of (C)APDs due to heterogeneity among studies. AIMS: This study aimed to review the possibility of using ABR evoked by click and/or speech stimuli to identify children with or at risk of (C)APDs. METHODS: The online databases of PubMed, Web of Science, Medline, Embase, and CINAHL were explored using combined keywords for all English and French articles published until April 2021. Additional gray literature was also included such as conference abstracts, dissertations, and editorials in ProQuest Dissertations. MAIN CONTRIBUTION: Thirteen papers met the eligibility criteria and were included in the scoping review. Fourteen papers were cross-sectional and two were interventional studies. Eleven papers used click stimuli to assess children with/at risk of (C)APDs, and speech stimuli were utilized in the remaining studies. Despite the diversity of the results, especially in click ABR assessments, most studies indicated increases in the wave latencies and/or decreases in the wave amplitudes of click ABR in children with/at risk of (C)APDs. The results of speech ABR assessments were more consistent, as prolongation of the transient components of speech ABR was observed in these children, while sustained components remained almost unchanged. CONCLUSIONS: Although both click and speech-evoked ABRs could be used to assess children with (C)APDs, it appears that speech-evoked ABR assessments yield more reliable findings. These findings, however, should be interpreted with caution given the heterogeneity among studies. Well-designed studies on children with confirmed (C)APDs using standard diagnostic and assessment protocols are recommended.

Long Latency Auditory Evoked Responses in the Identification of Children With Central Auditory Processing Disorders: A Scoping Review.

PURPOSE: The long latency auditory evoked responses (LLAERs), originating in the auditory cortex, are often considered a biomarker for maturity in the central auditory system and may therefore be useful in the evaluation of children with central auditory processing disorder (CAPD). However, the characteristics of the LLAERs elicited in this population have not been widely described, and clinical applications remain unclear. The goal of this scoping review was to investigate if LLAERs can be used to identify children with CAPD. METHOD: A systematic search strategy was used to identify studies that analyzed the latencies and amplitudes of P1, N1, P2, and N2 waveforms of the LLAERs. The online databases, including Embase, Web of Science, MEDLINE, PubMed, ProQuest, and CINAHL, as well as the gray literature were searched for papers published in English and French between January 1980 and May 2021. RESULTS: Seventeen papers met the eligibility criteria and were included in the study. Four papers had pre- and posttraining study designs, and the remaining studies were cross-sectional. Several studies reported significant differences in LLAERs between children with CAPD and their normal-hearing peers, and the results tended toward longer latencies and smaller amplitudes regardless of LLAER waves considered. N1 and/or N2 results were most likely to reveal significant differences between children with CAPD and normal-hearing controls and could potentially be considered a biomarker for CAPD. CONCLUSIONS: It seems that LLAER assessments, especially waves N1 and N2, might assist in better identification of CAPD children. However, considering heterogeneity in the methodology among the included studies, the results should be interpreted with caution. Well-designed studies on children with confirmed CAPD using standard diagnostic and assessment protocols are suggested.

Vestibular Hypersensitivity in Patients with Chronic Noise Exposure.

It has been demonstrated that high-intensity noise exposure adversely affects the human balance function. The Tullio phenomenon (TP) refers to sound-induced imbalance which is resulted from hypersensitivity of vestibular end organs to normal acoustic stimuli. Although different etiologies have been attributed to TP, evidence on the role of excessive noise exposure in the development of this symptom is limited. The present study aims to assess the vestibular functions in patients manifesting TP symptom who were exposed to long-term excessive noise levels. This was an analytic cross-sectional study conducted on 17 males diagnosed with TP with a history of chronic noise-induced hearing loss (TP group) and 17 healthy individuals. All subjects in both groups underwent complete otological, videonystagmography (VNG), and cervical vestibular myogenic potential (cVEMP) assessments. The most common complaint in TP subjects was vertigo and imbalance. During the VNG assessment, we found abnormal positional nystagmus and caloric irrigation (vestibular hyperfunction) results in 4 (23.53%) and 9 (52.94%) patients, respectively. Seven (41.17%) patients indicated cVEMP thresholds which were abnormally lower than the normal values ( ≤ 70 dB HL). However, when both VNG and cVEMP results were considered together, the abnormal rate reached 70.58% (12 of 17 cases). Our findings showed that both the semicircular canal as well as otolith stuctures could be affected in TP patients with a history of chronic noise exposure.

Cochlear implant outcomes in children with attention-deficit/hyperactivity disorder: Comparison with controls.

OBJECTIVES: The coincidence of attention-deficit/hyperactivity disorder (ADHD) and hearing loss in the children has adverse effects in speech, cognition, communication and motor development. This can influence cochlear implant (CI) outcomes negatively. The aim of this study was to compare auditory, language, speech, cognition, communication and motor outcomes between CI children with versus without ADHD. METHODS: Nineteen CI children with ADHD and twenty-three age and gender matched children without ADHD at the Shiraz CI center ranging in age from 37 to 60 months were participated in this cross-sectional study. The developmental quotient in auditory, receptive and expressive language, speech and cognition skills was evaluated through Newsha Developmental Scale. The Persian version of the Ages and Stages Questionnaire (ASQ) was used to assess children's developmental status in fine and gross movements, communication, problem solving, and personal-social domains. A comparison of the results between two groups was made by the Mann-Whitney test. RESULTS: CI children with ADHD had significantly lower Newsha developmental quotients in cases of auditory, receptive and expressive language, speech and cognition skills compared to the control group (P = 0.027 to <0.001). A significant difference was observed between children with and without ADHD in fine and gross movements, communication, problem solving, and personal-social domains of ASQ at 60 months (P = 0.029 to 0.003). CONCLUSION: Children with ADHD showed decreased ability in auditory, language, speech, cognition, motor and communication skills following CI compared to children without ADHD. It can guide clinician to provide these children with more specific rehabilitation program to improve their skills.

Association Between Tinnitus and Temporomandibular Disorders: A Systematic Review and Meta-Analysis.

OBJECTIVES: Tinnitus is one of the most common otological symptoms in patients with temporomandibular disorders. This study aimed to investigate the possible association between tinnitus and temporomandibular disorders. METHODS: The online databases of PubMed, Ovid, ScienceDirect, and Web of Science were explored for all English articles published until September 2018 using the combined keywords tinnitus and temporomandibular. Cross-sectional, cohort, or case-control studies that investigated the association between tinnitus and temporomandibular disorders (TMDs) were considered. The quality of the included papers was assessed by the Crowe Critical Appraisal Tool. RESULTS: Twenty-two papers met the eligibility criteria and were included in the systematic review. Meta-analysis was performed on 8 papers to investigate the possible relationship between tinnitus and TMDs by calculating the odds ratios. Odds ratios ranged from 1.78 to 7.79 in the studies related to tinnitus frequency in temporomandibular disorders and from 1.80 to 7.79 in the papers linked to temporomandibular disorder frequency in tinnitus, indicating a significant association between tinnitus and temporomandibular disorders. CONCLUSIONS: There was a strong relationship between tinnitus occurrence and TMDs. The findings implied the significance of exploring the signs of TMDs in patients with tinnitus as well as tinnitus in those who complain from temporomandibular disorders.

Tinnitus Impacts on Speech and Non-speech Stimuli.

OBJECTIVE: To investigate how tinnitus affects the processing of speech and non-speech stimuli at the subcortical level. STUDY DESIGN: Cross-sectional analytical study. SETTING: Academic, tertiary referral center. PATIENTS: Eighteen individuals with tinnitus and 20 controls without tinnitus matched based on their age and sex. All subjects had normal hearing sensitivity. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: The effect of tinnitus on the parameters of auditory brainstem responses (ABR) to non-speech (click-ABR), and speech (sABR) stimuli was investigated. RESULTS: Latencies of click ABR in waves III, V, and Vn, as well as inter-peak latency (IPL) of I to V were significantly longer in individuals with tinnitus compared with the controls. Individuals with tinnitus demonstrated significantly longer latencies of all sABR waves than the control group. The tinnitus patients also exhibited a significant decrease in the slope of the V-A complex and reduced encoding of the first and higher formants. A significant difference was observed between the two groups in the spectral magnitudes, the first formant frequency range (F1) and a higher frequency region (HF). CONCLUSIONS: Our findings suggest that maladaptive neural plasticity resulting from tinnitus can be subcortically measured and affects timing processing of both speech and non-speech stimuli. The findings have been discussed based on models of maladaptive plasticity and the interference of tinnitus as an internal noise in synthesizing speech auditory stimuli.

Effect of Age, Gender and Hearing Loss on the Degree of Discomfort Due to Tinnitus.

INTRODUCTION: Tinnitus is one of the complex symptoms of hearing described as a phantom auditory sensation without any external stimulation. Due to the subjective nature of tinnitus, perception and discomfort of tinnitus vary among the patients. The main aim of this study is to investigate the effects of gender, age and the degree of hearing loss on discomfort due to tinnitus. METHODS: Eighteen patients with tinnitus, aged 21-72 years, (9 males and 9 females) were recruited. Tinnitus discomfort was investigated by Tinnitus Handicap Inventory (THI) questionnaire. Psychoacoustic assessments of tinnitus and auditory threshold assessments were evaluated using a 2-channel clinical audiometer. RESULTS: The results showed no significant correlation between THI scores with loudness matching (P=0.187), mean of auditory threshold (P=0.304), gender (P=0.93) and age (P=0.200). Also, no significant correlation was found between maximal level of hearing loss and pitch matching (P=0.208). CONCLUSION: The study findings suggests that tinnitus is not correlated with age, gender and hearing loss. Overall, tinnitus is a complicated clinical condition which its real impact and degree of discomfort are unclear. More investigation is needed to clarify the factors involving in tinnitus annoyance.