The relationship between cardiovascular disease and hearing loss has already been proven. However literature does not provide information on the prevalence of hearing loss in adults with cardiovascular disease. Previous studies provide contradictory information regarding the audiological characteristics in this population. Data relating to the South African context is minimal. The objectives of this descriptive survey research study were to describe the prevalence of hearing loss in adults with this cardiovascular disease and determine the variables which may influence hearing thresholds in this population. Ninety two individuals diagnosed with coronary artery disease or cardiomyopathy were recruited using a non-probability, purposive sampling strategy. This sample, with an average age of 48 years and five months, consisted of more males than females and more participants with coronary artery disease than cardiomyopathy. Participants underwent a comprehensive audiological evaluation including an otoscopic examination, immittance audiometry, pure-tone audiometry, speech audiometry, as well as distortion product otoacoustic emissions. Content analysis, descriptive statistics, t-tests and an analysis of covariance revealed a hearing loss prevalence of 5%. These participants presented with a low frequency sensorineural hearing loss with the right ear being more affected. It was found that duration of cardiovascular disease influenced hearing thresholds. Implications of this study include the importance of prevention and early identification of hearing loss. This highlights the need to establish the role of audiologists within a multi-disciplinary team and the management of individuals with this disease.

Purpose: Otitis media is a global middle ear disease with health and economic burden especially in Africa and other developing nations. Chronic suppurative otitis media is an important cause of preventable hearing loss which warrants attention; particularly in the developing world, as it may have important socio-economic implications over and above patients’ quality of life. When presenting with an infected ear due to chronic suppurative otitis media, one may have impaired hearing and a perforated eardrum/s. Thus a type 1 tympanoplasty, i.e. myringoplasty operation is indicated to seal the eardrum. A review of literature demonstrates that extensive evidence exists on the success rate and efficacy of myringoplasty surgery in terms of audiological improvement worldwide; however there is paucity of evidence within the developing world context. Numerous studies published are from developed countries which are vastly different to developing countries. Thus this study aimed to explore audiological function in a group of adults following myringoplasty within a developing country context. Participants: Participant files from the last six years were obtained from the Ear, Nose and Throat (ENT) and Audiology departments at two academic hospitals in Gauteng, Johannesburg. The total sample comprised of 52 participant files consisting of, 20 males (38%) and 32 females (62%), with ages ranging from 18-63years with a mean age of 39.9 years. All 52 participant files could not be included in all the analysis due to missing biographical and/or audiological information in some of the files. Design: This study was conducted using a retrospective record review quantitative research design; where specific objectives of the study were explored. These included; a description and comparison of hearing function pre and post myringoplasty and an exploration of the possible influence of factors such as HIV/AIDS and type of surgical technique on hearing outcome post-surgery. Data analysis: Data was analysed using both descriptive and inferential statistics. Inferential statistics in the form of Kolmogorov-Smirnov two sample test and two-tailed paired (dependent) t-test were used to establish statistical significance levels to determine where statistically significant changes occurred pre and post-operatively and to establish if these changes were dependent on specific variables (HIV status and type of surgical technique). Results: Clinically overall hearing improved post-operatively in terms of tympanometry, pure tone audiometry (air-conduction and bone-conduction testing) and speech reception threshold testing. The predictors for improved hearing outcome post-operatively were; HIV negative status and butterfly cartilage inlay surgery as a surgical technique adopted. Although clinically hearing outcomes improved post-operatively at all air-conduction frequencies; statistically the changes in air-conduction hearing function were only statistically significant at specific frequencies. HIV/AIDS appeared to have an influence on hearing outcome post surgery when investigating clinically but these changes were only statistically significant mainly in HIV negative patients at three air-conduction frequencies. No statistically significant differences were found in mean change in hearing function in both HIV negative and positive patients at all bone-conduction thresholds. Although the type of surgical technique (specifically the butterfly cartilage inlay surgery) had an influence on hearing outcome post-surgery; these changes in air-conduction hearing function in patients who underwent this surgical technique were only statistically significant at specific frequencies. For patients who underwent fascia underlay, no statistically significant changes were found postoperatively. Conclusion: Current findings offer valuable baseline evidence on hearing outcome pre and post myringoplasty within this developing country context. This evidence can serve as a baseline for future research in the South African population. The study yielded relevant information regarding variables affecting the outcome of myringoplasty surgery in a South African context which is essential in the management of patients from an audiological and surgical perspective.

Cisplatin is a potent chemotherapeutic agent that is commonly used to treat a wide variety of tumours. Although highly effective, its administration is complicated by its ototoxic effect, a well known side effect that occurs in a significant number of patients. The hearing loss observed is typically irreversible, progressive, bilateral, high-frequency sensorineural hearing loss associated with tinnitus. At present there is no approved method for protecting or remedying against deterioration of hearing status, therefore, the detection and appropriate management of cisplatin-induced ototoxicity is reliant on effective audiological monitoring. The present study aimed to investigate the prevalence of ototoxicity in head and neck oncology patients who received cisplatin in combination with cranial irradiation. In addition, the study also aimed to examine the current state of audiological monitoring for this population at Christchurch Hospital. Post-treatment diagnostic audiological assessments were performed for 23 participants. The post-treatment assessment battery included case history, standard pure-tone audiometry (0.25 – 8 kHz), extended high-frequency audiometry (9 – 16 kHz), speech audiometry, tympanometry, acoustic reflexes and distortion product otoacoustic emissions. Prior to the assessments, a search of the Christchurch Audiology and Ear, Nose and Throat (ENT) Department oncology audiogram files was undertaken to match any previous audiograms to participating individuals. The results showed that pre-treatment assessment had been performed for 16 of the 23 participants. Of those 16, 15 participants experienced a significant cochleotoxic change in their hearing thresholds according to the ASHA criteria. One participant only received one dose of cisplatin due to deteriorating hearing, while one other participant elected to stop cisplatin treatment after the first dose due to a significant increase in tinnitus severity. Ototoxicity resulting from cisplatin chemotherapy constitutes a significant clinical problem that may have serious vocational, educational, and social consequences. Findings from this study highlight the importance of effective audiological monitoring for the timely detection and appropriate management of cisplatin-induced ototoxicity.

Assessing self-efficacy in families of children with hearing concerns through an audiological early intervention training. Abigail Lesley, B.S., Karee Diem, B.S., and Marcy Hite, Au.D., Ph.D., Department of Audiology and Speech Pathology, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Johnson City, TN. For children with hearing loss, spoken language outcomes are best when children have optimal auditory access through the consistent use of appropriately fitted hearing devices and are exposed to a rich linguistic environment. Parents can play a large role in facilitating their children’s use of hearing devices and supporting their language development. The purpose of this study was to improve of parent self-efficacy, increase family knowledge on language outcomes, and increase consistent use of amplification by providing an educational workshop to families with children identified with hearing loss and/or hearing concerns. The hypothesis of this study was to see an enhancement of self-efficacy skills within parent participants to empower and grow confidence in their ability to optimize their child’s amplification use and linguistic exposure. Participants were educated on the impact of hearing loss and/or hearing concerns on language development, importance of language exposure, use and care of amplification for families that utilize hearing technology, and empowerment to establish consistent device use. Assessment of self-efficacy skills in parents were measured through a pre- and post-survey distributed to participants. Survey and study were modeled after Ambrose et al., 2020 using the Scale of Parent Involvement and Self-Efficacy-Revised (SPISE-R). It queries parents about their child’s hearing device use and their perceptions of their own beliefs, knowledge, confidence, and actions pertaining to supporting their child’s auditory access and spoken language development. Ambrose et al., 2020 found the SPISE-R to be a promising tool for use in early intervention to better understand parents’ strengths and needs pertaining to supporting their young child’s auditory access and spoken language development. A total of nine parents were in attendance of the educational workshop conducted with only three participants completing both the pre- and post-survey. An analysis using a paired samples t-test revealed no statistically significant difference between the pre- and post-survey across all categories assessed within the SPISE-R apart from one question within the ‘Confidence’ category. Parents were found to have a significantly worse score between pre- and post-survey responses in the ‘Confidence’ category for the following question “If applicable, Put and keep my child’s hearing device(s) on him/her”. The overall mean significantly decreased between the pre- and post-survey, indicating less confidence with this skill. It should be noted, limited parent responses impacted the statistical analysis performed. Although the overall findings were not statistically significant, moving forward, data findings will be used to appropriately adjust the audiological early intervention training to improve self-efficacy skills of parents.

Syftet med studien var att utifrån specifika frågeställningar systematiskt granska vetenskapliga studier av audiologisk grupprehabilitering. I studien undersöktes själva definitionen av audiologisk grupprehabilitering, hur olika variabler påverkar resultatet, hur utvärderingen bör ske samt hur den förhåller sig till de uppställda målen.     Den metod som tillämpats är litteraturstudie. För litteratursökningen till denna studie användes databaserna PubMed och Cinahl. Vissa artiklar söktes även från vetenskapliga studiers referenslistor samt tips från handledare.       Resultaten från de olika studierna visar att nytta med rehabilitering varierar då många aspekter spelar in och påverkar utgången av rehabiliteringsinsatsen. Rehabiliteringen bör ses som en patientcentrerad problemlösande process för att nå alla individers önskemål. När patienten själv är mer aktiv i utvärderingen ökar möjligheten att uppnå målen gällande grupprehabilitering. Hänsyn måste tas till varje enskild individs sociala bakgrund för att skapa ett audiologiskt rehabiliteringsprogram som möter deras krav vid lyssnande och kommunikation. Individens livsstil, kommunikationsvanor, krav och egenheter interagerar med fysiska begrepp såsom graden och formen på hörselnedsättningen.    Audiologisk grupprehabilitering är en åtgärd för att förbättra eller lindra problem vid hörselnedsättning och de olika studierna visar på varierande resultat. Grupprehabiliteringens mål skall möta patientens behov. För att nå dit behövs utvärderingsmetoder som är personcentrerade och problemlösande. Användandet av öppna frågeformulär är ett sätt att nå det kriteriet. / The purpose with this study was to systematically examine scientific studies of audiologic group rehabilitation. The definition of audiological rehabilitation was explored, different variables that influence the result and how the outcome measures should be done and its relationship with the goals of audiologic rehabilitation.    The method used was a literature study. Pubmed and Cinahl were used for the search of literature. Some articles were searched from scientific studies reference lists and also advice from the supervisor.   The result from the different studies shows that the effect of rehabilitation varies as there are many aspects that have an affect on the outcome measure. Rehabilitation should be seen as a patient centered problem solving process in order to reach the goals of all the individuals. When the patient is more active in the outcome measure procedure the goals also comply with the group rehabilitation. Consideration must be taken to social background of each and every individual in order to create an audiological rehabilitation program that meets their hearing and communication requirements.  The lifestyle, communication habits and singularity of the individual interact with physical conceptions as well as the grade and shape of the hearing impairment.   Audiological group rehabilitation is a mean to improve or relieve problems due to hearing impairment and the different studies show that the result varies. The goals of group rehabilitation should meet the need of the patient. In doing so there is a need of outcome measures that are person centered and problem solving. Using open questionnaires is a method to reach that criterion. / <p>Examensarbete inom audionomprogrammet, Göteborgs universitet. </p>

Objective: To determine the feasibility of audiological screening in low-risk neonates, using Otoacoustic Emissions (OAEs), at various test times following birth. The achievability of a screening programme within the Midwife Obstetric Unit (MOU) 3-day assessment clinic at the Phola Park Community Health Centre (PPCHC) was deliberated. Participants: Two hundred and seventy two neonates were included in this study. Design: A prospective and longitudinal design was employed. Methods and Materials: Case history interviews, otoscopic examinations and Distortion Product Otoacoustic Emissions (DPOAEs) were carried out at two sessions. The initial session took place within 6 hours after birth and the second session at approximately 3 days after birth at the MOU 3-day assessment clinic. Data Analysis: Data was collected as “pass” and “refer” screening results, the number of births was compared to the number of participants at the two sessions. The number of “pass” and “refer” results per session were analysed and results per participant at the two sessions were compared to detect false-positives. The return for follow-up rate was considered. Results: Screening is possible within hours of birth but is more practical and efficient at the MOU 3-day assessment clinic. During the study, 260 neonates were born at PPCHC, 38.07% of these were screened at session 1 and a total of 268 newborns were screened at session 2. The pass rate was 16.16% at session 1 and 99.25% at session 2; rendering a false-positive rate of 82.10% at session 1. Time of birth relative to discharge, resources, environmental factors, noise levels, return for follow-up rate and referral rate have been identified as factors that may impact the practicability and efficiency of screening. Conclusion: Outcomes of the study highlight the importance of studying methodologies to ensure effective reach for hearing screening within the South African context. Based hereon, screening neonates immediately after birth is possible. However, it is recommended that screening forms part of the MOU 3-day assessment protocol to ensure that a higher number of neonates are reached when confounding factors such as vernix have plummeted; hence decreasing false- positives.

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Book Summary: Hyperacusis and Disorders of Sound Intolerance: Clinical and Research Perspectives is a professional resource for audiology practitioners involved in the clinical management of patients who suffer from sound tolerance concerns. The text covers emerging assessment and intervention strategies associated with hyperacusis, disorders of pitch perception, and other unusual processing deficits of the auditory system. In order to illustrate the patients perspectives and experiences with disorders of auditory processing, cases are included throughout. This collection of diagnostic strategies and tools, evidence-based clinical research, and case reports provides practitioners with avenues for supporting patient management and coping. It combines new developments in the understanding of auditory mechanisms with the clinical tools developed to manage the effects such disorders exert in daily life. Topics addressed include unusual clinical findings and features that influence a patient s auditory processing such as their perceptual accuracy, recognition abilities, and satisfaction with the perception of sound. Hyperacusis is covered with respect to its effects, its relation to psychological disorders, and its management. Hyperacusis is often linked to trauma or closed head injury and the text also considers the management of patients with traumatic brain injury as an opportunity to illustrate the effectiveness of interprofessional care in such cases. Interventions such as cognitive behavioral therapy, self-efficacy training, and hearing aid use are reported in a way that enhances clinicians' ability to weave such strategies into their own work, or into their referral system. Hyperacusis and Disorders of Sound Intolerance illuminates increasingly observed auditory-related disorders that challenge students, clinicians, physicians, and patients. The text elucidates and reinforces audiologists contributions to polytrauma and interprofessional care teams and provides clear definitions, delineation of mechanisms, and intervention options for auditory disorders.

Bakgrund: Audiologisk rehabilitering definieras som interventioner i form av instruktion, counseling, hörapparatutprovning och kommunikationsträning vilka används för att minska hörselnedsättningens påverkan på individens funktion, aktivitet, medverkan och livskvalitet. Audiologisk rehabilitering kan utföras såväl individuellt som i grupp. Grupprehabilitering kan vara kostnadseffektivt. Frågan är om audiologisk grupprehabilitering har några positiva effekter och om detta format kan anses likvärdigt med individuell rehabilitering. Syfte: Syftet med studien är att beskriva audiologisk grupprehabilitering och dess eventuella effekter. Metod: En systematisk litteraturstudie genomfördes. Resultat: Litteraturen pekar på att audiologisk grupprehabilitering är kostnadseffektiv och bidrar med vissa positiva psykosociala effekter för individen och dennes anhöriga. Det har framkommit att det är positivt för individen att träffa andra i en liknande situation. Detta arbete har inte kunnat visa på något entydigt samband mellan de positiva effekterna och rehabiliteringens utförande. Slutsatser: Audiologisk grupprehabilitering kan, med stöd i vetenskaplig litteratur, erbjudas till patienter då denna håller samma kvalitet som individuell och medför vissa positiva psykosociala aspekter för patienten och dennes anhöriga samt är kostnadseffektiv.

In the clinical routine of an audiologist, it is becoming more frequent the complaints about speech misunderstanding in a noisy environment. Audiological tests which use sentences as stimulus have been object of research because, besides examining the real auditory skill of the patient, they promote a direct approximation to communicative situations and provide information that will indicate the most adequate behavior to be recommended to the patient with hearing deficits. The aim of this study was to determine sentences recognition thresholds in free field, with the presence and the absence of competitive noise, in a group of participants with neurossensorial hearing loss of a moderate level. It was examined 50 participants, 27 men and 23 women, aged between 45 and 76. Firstly, it was carried out anamnesis, meatuscopy, threshold tonal audiometry, SRT and SRPI tests. Next, using the Portuguese Sentences Lists test (PSL, 1998), SRTQ and SRTN tests were carried out, with a fixed noise level of 65 dB A. The average SRTQ was 60,90 dB A, the average SRTN in the same group was 68,20 dB A and the average S/N ratio was + 3,20 dB A. The inclusion of tests in free field using sentences as stimulus, with and without competitive noise, after the basic audiological evaluation in a patient with hearing deficits, have brought answers broader than the skills to detect the presence of pure tones and to recognize isolated words. These tests assess the patient as a whole, simulating communicative situations as well as providing data about skills and limitations of each person which determine his/her communication capacity. / Na rotina clínica do audiologista, a cada dia tornam-se mais freqüentes as queixas de dificuldade de compreensão de fala em ambiente ruidoso. Testes audiológicos que utilizam sentenças como estímulo, tem sido objeto de pesquisa, pois além de verificarem a real habilidade auditiva do paciente, proporcionam uma aproximação direta com situações de comunicação e fornecem informações que vão orientar a conduta mais adequada a ser indicada para o indivíduo com queixa de distúrbios de audição. O objetivo desta pesquisa foi determinar os limiares de reconhecimento de sentenças em campo livre, com a presença e ausência de ruído competitivo, em um grupo de indivíduos portadores de perda auditiva neurossensorial de grau moderado. Foram avaliados 50 indivíduos, sendo 27 homens e 23 mulheres, com idades entre 45 e 76 anos. Inicialmente, realizou-se anamnese, meatoscopia, audiometria tonal liminar, pesquisa do LRF e do IPRF. Posteriormente, utilizando o teste Listas de Sentenças em Português (LSP, 1998), realizou-se inicialmente a pesquisa dos LRSS e a seguir o LRSR, com um nível fixo de ruído de 65 dB A. O LRSS médio obtido foi de 60,90 dB A, o LRSR médio encontrado neste mesmo grupo foi de 68,20 dB A e a média das relações S/R encontrada foi de + 3,20 dB A. A inclusão dos testes em campo livre, utilizando sentenças como estímulo, com e sem a presença de ruído competitivo, após a avaliação audiológica básica, em indivíduo com distúrbio da audição possibilita a obtenção de respostas que vão além das habilidades para detectar a presença de tons puros e reconhecer palavras isoladas. Estes testes avaliam o indivíduo como um todo, simulando situações de comunicação, fornecendo dados sobre as habilidades e limitações de cada indivíduo, que determinam a sua capacidade de comunicação.