Displaying all 6 publications

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  1. Wali HA, Mazlan R, Kei J
    Ear Hear, 2019 2 27;40(5):1233-1241.
    PMID: 30807541 DOI: 10.1097/AUD.0000000000000707
    OBJECTIVES: Wideband absorbance (WBA) is an emerging technology to evaluate the conductive pathway (outer and middle ear) in young infants. While a wealth of research has been devoted to measuring WBA at ambient pressure, few studies have investigated the use of pressurized WBA with this population. The purpose of this study was to investigate the effect of age on WBA measured under pressurized conditions in healthy infants from 0 to 6 months of age.

    DESIGN: Forty-four full-term healthy neonates (17 males and 27 females) participated in a longitudinal study. The neonates were assessed at 1-month intervals from 0 to 6 months of age using high-frequency tympanometry, acoustic stapedial reflex, distortion product otoacoustic emissions, and pressurized WBA. The values of WBA at tympanometric peak pressure (TPP) and 0 daPa across the frequencies from 0.25 to 8 kHz were analyzed as a function of age.

    RESULTS: A linear mixed model analysis, applied to the data, revealed significantly different WBA patterns among the age groups. In general, WBA measured at TPP and 0 daPa decreased at low frequencies (<0.4 kHz) and increased at high frequencies (2 to 5and 8 kHz) with age. Specifically, WBA measured at TPP and 0 daPa in 3- to 6-month-olds was significantly different from that of 0- to 2-month-olds at low (0.25 to 0.31 kHz) and high (2 to 5 and 8 kHz) frequencies. However, there were no significant differences between WBA measured at TPP and 0 daPa for infants from 3 to 6 months of age.

    CONCLUSIONS: The present study provided clear evidence of maturation of the outer and middle ear system in healthy infants from birth to 6 months. Therefore, age-specific normative data of pressurized WBA are warranted.

  2. Handscomb L, Shorter GW, Hoare DJ, Hall DA
    Ear Hear, 2020 2 8;41(4):1028-1039.
    PMID: 32032227 DOI: 10.1097/AUD.0000000000000826
    OBJECTIVES: There is a great deal of variation in the extent to which people with tinnitus find it distressing, which cannot be explained solely by differences in perceived loudness. The Cognitive Behavioral Model of Tinnitus Distress proposes that tinnitus becomes and is maintained as a distressing problem due to a process of interaction between negative thoughts, negative emotions, attention and monitoring, safety behavior, and beliefs. This study used path analysis to assess how well different configurations of this model fit using questionnaire data obtained from people with tinnitus.

    DESIGN: This was a cross-sectional study. Three hundred forty-two members of the public with tinnitus volunteered to complete a survey comprising a series of questionnaires and subscales of questionnaires measuring each of the constructs contained within the Cognitive Behavioral Model of Tinnitus Distress. The optimum factor structure of each measure for the study population was established, and the resulting factors were used to construct a series of path models based on the theoretical model. Path analysis was conducted for each of these, and the goodness of fit of the models was assessed using established fit criteria.

    RESULTS: Five of the six path models tested reached the threshold for adequate fit, and further modifications improved the fit of the three most parsimonious of these. The two best-fitting models had comparable fit indices which approached the criteria for good fit (Root Mean Square Error of Approximation = 0.061, Comparative Fit Index = 0.984, Tucker Lewis Index = 0.970 and Root Mean Square Error of Approximation = 0.055, Comparative Fit Index = 0.993, Tucker Lewis Index = 0.982). They differed principally in the placement of tinnitus magnitude and the inclusion/noninclusion of control beliefs.

    CONCLUSIONS: There are theoretical arguments to support both a beliefs-driven and a loudness-driven model, and it may be that different configurations of the Cognitive Behavioral Model of Tinnitus Distress are more appropriate to different groups of people with tinnitus. Further investigation of this is needed. This notwithstanding, the present study provides empirical support for a model of tinnitus distress which provides a clinical framework for the development of more effective psychological therapy.

  3. Zakaria MN, Abdullah R, Nik Othman NA
    Ear Hear, 2018 11 22;40(4):1039-1042.
    PMID: 30461445 DOI: 10.1097/AUD.0000000000000676
    OBJECTIVES: Post-auricular muscle response (PAMR) is a large myogenic potential that can be useful in estimating behavioral hearing thresholds when the recording protocol is optimal. The main aim of the present study was to determine the influence of stimulus repetition rate on PAMR threshold.

    DESIGN: In this repeated-measures study, 20 normally hearing adults aged between 18 and 30 years were recruited. Tone bursts (500, 1000, 2000, and 4000 Hz) were used to record PAMR thresholds at 3 different stimulus repetition rates (6.1/s, 11.1/s, and 17.1/s).

    RESULTS: Statistically higher PAMR thresholds were found for the faster stimulus rate (17.1/s) compared with the slower stimulus rate (6.1/s) (p < 0.05). For all stimulus rates and frequencies, significant correlations were found between PAMR and pure-tone audiometry thresholds (r = 0.62 to 0.82).

    CONCLUSIONS: Even though the stimulus rate effect was significant at most of the tested frequencies, the differences in PAMR thresholds between the rates were small (<5 dB). Nevertheless, based on the correlation results, we suggest the use of 11.1/s stimulus rate when recording PAMR thresholds.

  4. Ismail AH, Armitage CJ, Munro KJ, Marsden A, Dawes PD
    Ear Hear, 2022 01 06;43(4):1103-1113.
    PMID: 34999593 DOI: 10.1097/AUD.0000000000001195
    OBJECTIVE: Provision of information is already part of standard care and may not be sufficient to promote hearing aid use. The I-PLAN is a behavior change intervention that is designed to promote hearing aid use in adults. It consists of a prompt, an action plan and provision of information. The objective was to test the effectiveness of the I-PLAN prompt and plan components in promoting hearing aid use and benefit. Hypotheses were: there would be greater hearing aid use, benefit, self-regulation, and hearing aid use habit among participants who received the prompt or plan component, compared with no prompt or no plan component, and the effect would be the greatest in participants who received both prompt and plan; and self-regulation and habit would mediate the effect of prompt and/or plan components on hearing aid use and benefit.

    DESIGN: A 2 x 2 factorial randomized controlled trial design. Two hundred forty new adult patients (60 in each group) were randomized to: information (info) only; info + prompt; info + plan; or info + prompt + plan. All participants received treatment as usual in addition to I-PLAN components, which were provided in a sealed envelope at the end of the hearing aid fitting consultation. Participants in the prompt group were instructed to use their hearing aid box as a physical prompt to remind them to use the device. Participants in the plan group were instructed to write an action plan to encourage them to turn their intentions into action. Participants, audiologists, and researchers were blinded to group allocation. The primary outcome was self-reported proportion of time hearing aids were used in situations where they had listening difficulties. Secondary outcomes were hearing aid use derived from data logging, self-reported hearing aid benefit, self-reported self-regulation, and habit. Outcomes were measured at 6-week post-fitting.

    RESULTS: Contrary to predictions, participants who received the prompt component reported using their hearing aid less than participants without the prompt (p = 0.03; d = 0.24). The mean proportion of time hearing aid were used was 73.4% of the time in the prompt group compared with 79.9% of the time in the no prompt group. Participants who received the plan component reported using their hearing aids more frequently than those who did not receive the plan (Meanplan = 81.0% vs Meannoplan = 71.8% of the time; p = 0.01; d = 0.34). Receiving both prompt and plan components did not change self-reported proportion of time hearing aids were used but data-logging use was significantly reduced. The prompt reduced self-regulation of hearing aid use compared with the no prompt (p = 0.04; d = 0.28), while the plan promoted stronger hearing aid use habits than the no plan group (p = 0.02; d = 0.30).

    CONCLUSIONS: Audiologists should consider using action plans to promote hearing aid use. Despite the decrease in hearing aid use when using the hearing aid box as a physical prompt, hearing aid use was still high (≈70% of the time). The hearing aid box may have slightly reduced hearing aid use by undermining self-regulation. Participants may have delegated responsibility for hearing aid use to the prompt. Subsequent studies should evaluate different prompts and test the long-term benefit of the plan on hearing aid use via habit formation.

  5. Lee OW, Mao D, Savkovic B, Wunderlich J, Nicholls N, Jeffreys E, et al.
    Ear Hear, 2023 01 14;44(4):776-786.
    PMID: 36706073 DOI: 10.1097/AUD.0000000000001325
    OBJECTIVES: Cardiac responses (e.g., heart rate changes) due to an autonomous response to sensory stimuli have been reported in several studies. This study investigated whether heart rate information extracted from functional near-infrared spectroscopy (fNIRS) data can be used to assess the discrimination of speech sounds in sleeping infants. This study also investigated the adaptation of the heart rate response over multiple, sequential stimulus presentations.

    DESIGN: fNIRS data were recorded from 23 infants with no known hearing loss, aged 2 to 10 months. Speech syllables were presented using a habituation/dishabituation test paradigm: the infant's heart rate response was first habituated by repeating blocks of one speech sound; then, the heart rate response was dishabituated with the contrasting (novel) speech sound. This stimulus presentation sequence was repeated for as long as the infants were asleep.

    RESULTS: The group-level average heart rate response to the novel stimulus was greater than that to the habituated first sound, indicating that sleeping infants were able to discriminate the speech sound contrast. A significant adaptation of the heart rate responses was seen over the session duration.

    CONCLUSION: The dishabituation response could be a valuable marker for speech discrimination, especially when used in conjunction with the fNIRS hemodynamic response.

  6. Zakaria MN, Salim R, Anual MSI, Patuzzi R
    Ear Hear, 2024 Feb 22.
    PMID: 38383959 DOI: 10.1097/AUD.0000000000001497
    OBJECTIVE: Various studies have been conducted to search for the most optimal stimulus for eliciting cervical vestibular evoked myogenic potential (cVEMP). More recently, there is a growing interest to study the usefulness of chirp stimuli in cVEMP recording. Nevertheless, contradictory outcomes have been reported across the studies, and further research with larger samples would be beneficial to provide better insight into this matter. As such, the present study was carried out to compare cVEMP results between narrowband (NB) CE-Chirp (centered at 500 Hz) and 500 Hz tone burst stimuli.

    DESIGN: In this study that employed a comparative study design, 98 normally hearing adults aged between 19 and 24 years were enrolled. All of them underwent the cVEMP testing based on the recommended test protocol. The stimuli were a 500 Hz tone burst and a NB CE-Chirp (360-720 Hz) presented through insert earphones at an intensity level of 120.5 dB peSPL.

    RESULTS: For each stimulus, cVEMP results did not differ significantly between the ears (p > 0.05). Relative to the 500 Hz tone burst, the NB CE-Chirp stimulus produced statistically shorter P1 and N1 latencies (p < 0.001). On the other hand, P1-N1 amplitude was found to be comparable between the two stimuli (p > 0.05).

    CONCLUSIONS: The present study did not find any supporting evidence that the NB CE-Chirp stimulus (centered at 500 Hz) outperformed the conventional 500 Hz tone burst in the cVEMP testing. Both stimuli are considered equally appropriate to record cVEMP responses in clinical settings.

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