Background: Unilateral hearing loss (UHL) is associated with speech-in-noise difficulties, impaired spatial hearing, and reduced social participation, yet conventional audiological assessments may not capture these real-world consequences. This study characterised the multidimensional functional impact of UHL using an ecologically oriented test battery and explored whether accessible behavioural and self-reported measures accounted for individual differences in speech-in-noise comprehension. Methods: Fifteen adults with moderate to profound sensorineural UHL and sixteen adults with normal hearing completed standardised questionnaires assessing hearing disability and social participation, an auditory reaction-time task in quiet and noise, the National Acoustic Laboratories Dynamic Conversations Test, head-orientation tracking, and post-task self-reports. Group differences were assessed using mixed-effects models and independent-samples t-tests. An exploratory regression examined speech-in-noise performance within the UHL group. Results: Participants with UHL reported greater hearing difficulties and social participation restrictions, and showed modestly poorer speech-in-noise comprehension although the UHL-NH difference in speech-in-noise comprehension was no longer statistically significant after adjustment for age. Reaction times were significantly longer in noise than in quiet but did not differ significantly between hearing groups. The UHL group also showed a significantly more pronounced head orientation towards the poorer-hearing side and greater within-participant head-orientation variability. An exploratory model combining reaction time in noise with three post-task self-report items showed strong apparent in-sample fit (adjusted R2 = 0.71). However, internal cross-validation of the complete model-selection procedure yielded substantially lower predictive performance (RCV2 = 0.19). Conclusions: UHL is associated with differences across complementary perceptual, behavioural, and self-reported dimensions of everyday communication. Multimodal functional assessment may provide information beyond conventional audiometry, although the exploratory model requires validation in larger, age-matched independent cohorts.

Background: Hyperacusis is a common, but often underrecognized comorbidity in patients with chronic subjective tinnitus. Reduced sound tolerance is associated with a greater tinnitus-related burden, impaired communication, reduced social participation, and poorer daily functioning. However, published data regarding its prevalence and clinical impact remain limited and inconsistent. Objectives: To determine the prevalence of hyperacusis in patients with chronic subjective tinnitus and to assess its association with tinnitus-related handicap, uncomfortable loudness levels, and degree of hearing loss and daily functioning. Methods: This cross-sectional study included 194 patients aged 21-85 years with chronic subjective tinnitus. Hyperacusis was assessed using a structured clinical interview that included questions on decreased sound tolerance and sound-induced ear pain and uncomfortable loudness level measurements (ULLs). Patients were categorized into two groups: tinnitus with hyperacusis (T + H; n = 32) and tinnitus without hyperacusis (T; n = 162). The impact of tinnitus on daily functioning was evaluated using a standardized and clinically validated questionnaire-the Tinnitus Handicap Inventory (THI). Data were analyzed using appropriate parametric and nonparametric statistical tests. Results: Hyperacusis was identified in 32 of 194 patients with chronic tinnitus (16.5%). Patients with tinnitus and hyperacusis (T + H) had significantly higher THI scores than those with isolated tinnitus, indicating greater tinnitus-related handicap (76.3 vs. 41.9; p < 0.001). Patients with hyperacusis also demonstrated significantly lower ULL values than those without hyperacusis (p < 0.001). Conclusions: Although the reported prevalence of hyperacusis among patients with tinnitus varies across the literature, our findings indicate that hyperacusis is a common comorbidity associated with significantly greater tinnitus-related handicap. Routine assessment of hyperacusis, including ULL measurements, should be incorporated into the clinical evaluation of patients with tinnitus to facilitate comprehensive diagnosis and optimize management. These findings highlight the importance of systematic assessment of hyperacusis in patients with tinnitus in routine audiological practice.

Background: There might be a significant association between hearing loss (HL) and cognitive performance or postural imbalance, but how they relate to each other remains unknown. The aim of this study is to gain an understanding of these relationships. Methods: An observational prospective study with subjects ≥ 55 years old divided into groups: normal hearing (group A), untreated HL > 20 decibel hearing level (dBHL) (group B), and patients with treated HL > 20 dBHL (group C). At the initial visit and follow-up, participants underwent tests and questionnaires evaluating hearing, balance, and cognition. Statistical analyses-including relative risk, Spearman's Rho correlation, interaction, and adjusted models-were performed using Stata 17; a p-value < 0.05 was considered statistically significant. Results: In total, 714 subjects were initially recruited: 210 in group A, 302 in group B, and 202 in group C. A mean follow-up time of 3.6 years was completed by 101 individuals. Compared with the normal-hearing group, hearing loss increased the probability of unsteadiness by 1.4-fold in group B and 4.1-fold in group C. Poorer performance on the Timed Up and Go (TUG) test was predicted by lower scores on both cognitive executive function tests, with correlations of -0.4 and 0.34 (p < 0.001). Regarding confounding factors, statistically significant differences were found for age and education in cognitive performance; age in the TUG results; and sex, cardiovascular risk factors (CVRF), and education in HL. Conclusions: Postural imbalance and cognitive executive function are related to HL. However, there is no evidence linking dizziness to cognitive executive function, although an association with TUG results was found. Therefore, HL is correlated with both balance and cognition, and cognition is also related to balance.

Chronic subjective tinnitus has been linked to impaired speech-in-noise perception, yet its impact on phoneme level processing remains unclear. We assessed phoneme discrimination in 49 normal hearing participants (26 with chronic subjective tinnitus and 23 matched controls), with matched audiometric thresholds and supra-threshold processing, and found no statistically significant differences between groups on the assessed cognitive measures, using a two-alternative forced-choice identification task with fricatives (/s, ʃ/) and plosives (/ph, t/) presented in quiet and individualized noise conditions. Performance on the tested fricative contrast was preserved in the tinnitus group (observed noise accuracy: 0.69 vs 0.73 in controls; model based group contrast, p=0.778). In contrast, plosive processing showed a selective alteration: tinnitus participants were significantly slower than controls in noise (model estimate +89 ms, p=0.002) despite comparable observed accuracy (0.47 vs 0.49; model-based group contrast, p=0.212). Controls exhibited a clear speed-accuracy trade-off (p<0.001), which was absent in tinnitus. These findings suggest a dissociation between preserved spectral processing and impaired temporal processing in tinnitus.

Understanding how altitude influences hearing aid performance is increasingly important as more users are exposed to high-altitude environments. A previous computational model predicted substantial output reductions near the first-resonance region but assumed that ear canal temperature followed ambient temperature, potentially overestimating resonance-related effects. The present study incorporated an ear canal temperature-gradient sensitivity model and evaluated its effects on predicted hearing aid output and speech audibility at sea level (0 m) and 4572 m using two representative hearing-loss profiles fitted with the National Acoustic Laboratories-Non-Linear Version 2 prescription. Across all temperature-gradient conditions, peak attenuation was reduced to less than 3 dB, compared with approximately 5.7 dB in the original uniform-temperature model, and decreased further to approximately 1.8-1.9 dB under the strongest thermal-regulation condition. A finer-resolution 18-band American National Standards Institute-style Speech Intelligibility Index analysis showed only small between-model differences, with maximum absolute differences at 4572 m of approximately 0.011 for the N3 audiogram and 0.002 for the N6 audiogram. These findings suggest that incorporating the temperature-gradient model substantially reduces predicted altitude-related resonance effects without producing a correspondingly large change in predicted speech audibility.

Standardized language tests guide eligibility for speech-language services in children who are deaf and hard-of-hearing (D/HH) and use spoken language. They must be sensitive enough to detect delays during critical early windows. Clinicians have noted that the Preschool Language Scale-Fifth Edition (PLS-5) may lack sensitivity to spoken language delays in young D/HH children, risking under-identification for intervention. We retrospectively compared standard scores from PLS-5 and Oral and Written Language Scales-Second Edition (OWLS-II) in 39 children using hearing aids and/or cochlear implants. Relative to OWLS-II, PLS-5 tended to yield higher standard scores in children under 3 years but lower standard scores in children older than 3.8 years. Clinicians should use caution when relying solely on the PLS-5 to determine eligibility for services in young children who are D/HH.