Seminars in Hearing

Tinnitus acoustic therapy is defined as any use of sound where the intent is to alter the tinnitus perception and/or the reactions to tinnitus in a clinically beneficial way. The parameters of sound that may cause beneficial effects, however, are currently only theorized with limited data supporting their effectiveness. Residual inhibition is the temporary suppression or elimination of tinnitus that is usually observed following appropriate auditory stimulation. Our pilot study investigated the effects of a therapeutic acoustic stimulus that was individually customized to maximize residual inhibition of tinnitus and extend its duration to determine if there could be a sustained suppression of the tinnitus signal (i...

The Veterans Affairs (VA) Rehabilitation Research & Development (RR&D) National Center for Rehabilitative Auditory Research (NCRAR) was first funded by the RR&D Service in 1997 and has been funded continuously since that time. The overall purpose of the NCRAR is to "improve the quality of life of Veterans and others with hearing and balance problems through clinical research, technology development, and education that leads to better patient care" ( www.ncrar.research.va.gov ). An important component of the research conducted at the NCRAR has been a focus on clinical and rehabilitative aspects of tinnitus...

Maintaining balance involves the combination of sensory signals from the visual, vestibular, proprioceptive, and auditory systems. However, physical and biological constraints ensure that these signals are perceived slightly asynchronously. The brain only recognizes them as simultaneous when they occur within a period of time called the temporal binding window (TBW). Aging can prolong the TBW, leading to temporal uncertainty during multisensory integration. This effect might contribute to imbalance in the elderly but has not been examined with respect to vestibular inputs...

Tinnitus is prevalent among military Veterans, yet there is a gap between the demand and the provision of services for tinnitus rehabilitation services within the Veterans Health Administration (VHA). We sought to understand tinnitus rehabilitation service needs and preferences among Veterans with bothersome tinnitus who use Veterans Affairs (VA) services. We conducted semistructured telephone interviews in 2019 with Veterans diagnosed with tinnitus, who reported it as bothersome. Veterans were purposively sampled to represent national VA users, with and without comorbid traumatic brain injury (TBI), and who were or were not interested in tinnitus rehabilitation services...

Speech-in-noise testing has been proposed as a useful part of the audiometric test battery dating back to the earliest years of the field of audiology. Many speech-in-noise tests have been developed and used to varying degrees. However, multiple barriers have prevented speech-in-noise testing from being used widely in the clinic. The purpose of this article is to provide a resource to audiologists and other hearing health professionals who want to know (1) what tests are available for use, (2) the rationale behind specific tests, and (3) important considerations when selecting one or more tests to use clinically...

Optical coherence tomography (OCT) is a novel technology for performing real-time high-speed and high-resolution cross-sectional imaging on the micro-scale in situ. It is analogous to ultrasound imaging, except that it uses light instead of sound. OCT has recently been introduced in auditory research to visualize the various structures of the ear with a minimally invasive operation. In addition, OCT can be used as a vibrometry system that is capable to detect sound-induced sub-nanometer vibrations of the middle and inner ear...

Tinnitus is highly prevalent among military Veterans. Severe tinnitus can be associated with negative impacts on daily life. Veterans with severe tinnitus may also have greater difficulties in functional roles, including work. However, few studies have explicitly explored this relationship. Traumatic brain injury (TBI), also prevalent among Veterans, is associated with tinnitus and can additionally impair work functioning. This quantitative investigation used a population-based survey to assess the relationship between tinnitus severity, measured using the Tinnitus Functional Index (TFI), and the impact of tinnitus on work, measured using a composite score from the Tinnitus History Questionnaire, among a stratified random sample of VA healthcare-using Veterans diagnosed with tinnitus, with and without comorbid TBI...

It has been established that blast exposure and brain injury can result in self-reported and measured auditory processing deficits in individuals with normal or near-normal hearing sensitivity. However, the impaired sensory and/or cognitive mechanisms underlying these auditory difficulties are largely unknown. This work used a combination of behavioral and electrophysiological measures to explore how neural stimulus discrimination and processing speed contribute to impaired temporal processing in blast-exposed Veterans measured using the behavioral Gaps-in-Noise (GIN) Test...

Workers rely on hearing protection devices to prevent occupational noise-induced hearing loss. This study aimed to evaluate changes in attenuation over time for properly fit devices when worn by workers exposed to hazardous noise. Earplug fit testing was accomplished on 30 workers at a brewery facility with three types of foam and three types of premolded earplugs. The personal attenuation ratings (PARs) were measured before and after a 2-hour work period while exposed to hazardous noise levels. The minimum acceptable initial PAR was 15 dB...

Noise-induced hearing loss (NIHL) continues to be a pervasive problem for the nation's workforce, particularly the nation's mining personnel. As one of the leading health and safety organizations in the world, the National Institute for Occupational Health and Safety (NIOSH) in Pittsburgh maintains a Hearing Loss Prevention Program (HLPP) to conduct research to reduce NIHL loss among the nation's miners. This document provides a brief overview of this HLPP, describing some of the research techniques involved in the development of engineering noise controls, methods for the development of administrative noise controls, and some of the products available to the public to protect the nation's workers hearing...

This study aimed to scope the literature, identify knowledge gaps, appraise results, and synthesize the evidence on the audiological evaluation of workers exposed to solvents. We searched Medline, PubMed, Embase, CINAHL, and NIOSHTIC-2 up to March 22, 2021. Using Covidence, two authors independently assessed study eligibility, risk of bias, and extracted data. National Institute of Health Quality Assessment Tools was used in the quality evaluation of included studies; the Downs and Black checklist was used to assess the risk of bias...

Responses to complaints about low-frequency noise and infrasound at workplaces have not been extensively documented in the literature. The National Institute for Occupational Safety and Health evaluated low-frequency noise, infrasound, and health symptoms among employees of an organization providing services to homeless persons. The organization's campus was evacuated after two loud noise and vibration incidents related to methane flare on an adjacent landfill. Employees were interviewed about health symptoms, perceptions of noise, and how the incidents were handled...

For more than 50 years, the National Institute for Occupational Safety and Health (NIOSH), part of the United States (U.S.) Centers for Disease Control and Prevention (CDC), has been actively working to reduce the effects of noise and ototoxic chemicals on worker hearing. NIOSH has pioneered basic and applied research on occupational hearing risks and preventive measures. The Institute has issued recommendations and promoted effective interventions through mechanisms ranging from formal criteria documents to blogs and social media...

The National Institute for Occupational Safety and Health (NIOSH) evaluated continuous and impact noise exposures and hearing loss among workers at a hammer forge company. Full-shift personal noise exposure measurements were collected on forge workers across 15 different job titles; impact noise characteristics and one-third octave band noise levels were assessed at the forge hammers; and 4,750 historic audiometric test records for 483 workers were evaluated for hearing loss trends. Nearly all workers' noise exposures exceeded regulatory and/or recommended exposure limits...

This study estimated the average annual number of U.S. workers' compensation (WC) claims for occupational hearing loss (OHL) and their associated cost and identified the industry/occupation classifications with the highest numbers of OHL claims. The most recent U.S. cost estimate ($242 million) was based on data from one state in 1 year (1991). WC data from the National Council on Compensation Insurance, Inc. (35 states) and two additional individual states were examined, incorporating data from 37 states and the District of Columbia...

The hearing healthcare industry is evolving rapidly. A framework addressing provision options in contemporary hearing care could assist clinician and client navigate their options to find the most appropriate solution for each individual. A PRISMA approach was used followed by mapping, validation, and thematic analysis to produce a framework to better describe and discuss service and product delivery options in contemporary hearing care. No frameworks were identified to advise matching needs with current provision options in audiological care...

There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss...

The continuous advancements in technologies supporting digital health and digital therapeutics (DTx) bring new possibilities to the field of audiology. This study considers a new DTx for tinnitus called Tinnibot and the willingness of a group of Australian university audiology students to consider this new DTx in their future careers as practicing audiologists. A single-group case-series design (pretest/posttest) was used to examine the opinions of 10 university audiology students before and after participating in a 2-hour information workshop on the topics of tinnitus, DTx, cognitive behavioral therapy, and a new digital therapy tool for tinnitus called Tinnibot...

Hearing care is expanding accessibility to consumers through new service delivery channels and methods of technology distribution (see Brice et al, this issue). This diversification has the potential to overcome longstanding consumer disparities (e.g., health, socioeconomic, psychological, environmental) in receiving care and provider constraints (e.g., accessibility, geography, direct access) to delivering care that adversely impacts quality of life (e.g., social isolation, depression, anxiety, self-esteem)...

Healthcare systems are traditionally a clinician-led and reactive structure that does not promote clients managing their health issues or concerns from an early stage. However, when clients are proactive in starting their healthcare earlier than later, they can achieve better outcomes and quality of life. Hearing healthcare and the rehabilitation journey currently fit into this reactive and traditional model of care. With the development of service delivery models evolving to offer services to the consumer online and where they are predominately getting their healthcare information from the internet and the advancement of digital applications and hearing devices beyond traditional hearing aid structures, we are seeing a change in how consumers engage in hearing care...